“An area of increasing need”, Sylvan Thomson

Representing Trans: Linguistic, Legal and Everyday Perspectives 
Evan Hazenberg and Miriam Meyerhoff (eds)
Victoria University Press, $40.00,
ISBN 9781776561759

 

The day before this review was due, my mother messaged me to say that she had heard an interview on RNZ featuring my former endocrinologist, Dr John Delahunt. Curious, I looked the segment up, and discovered that it was prompted by an article published the same day in the New Zealand Medical Journal. The article, snappily titled “Increasing rates of people identifying as transgender presenting to Endocrine Services in the Wellington region”, describes a marked jump in those seeking referrals for therapy related to gender-reassignment, and a particularly steep increase in referrals for those under the age of 30. The study claims that the climb in numbers is “likely to be related to the increasing societal awareness and acceptance of gender diversity”, and Dr Delahunt, one of the study’s authors, concluded that the article was largely directed at health professionals, intended to “highlight an area of increasing need”.

Reading these words was very heartening. Heartening because I have spent the last couple of weeks reading and thinking about Representing Trans: Linguistic, Legal and Everyday Perspectives, a wide-ranging collection of essays, mostly academic in tone, which examines the trans experience in Aotearoa New Zealand and beyond. Heartening not because this collection of essays was depressing or hopeless, but rather because this remark of Dr Delahunt’s about “an area of increasing need” seems to respond directly to the the book’s battle-cry. Whether writing in medical, academic, cultural, legal, or linguistic contexts, many of the authors in Representing Trans remark on the desperate need for our institutions to keep up with the increasingly diverse people they are supposed to serve. Perhaps that article, published in the New Zealand Medical Journal and deliberately aimed at addressing this need, might lead to real, on-the-ground changes that make accessing health services easier for trans and non-binary people. Perhaps this journal article could contribute to a broader re-assessment of how difficult it can be for trans people to navigate areas that most others take for granted. Perhaps.

Representing Trans is a book that made me think about how inescapable our institutions are. I don’t want to go full-on Foucault-Panopticon here, but we are, unavoidably, enmeshed in the law, enmeshed in our health care system, enmeshed – in a more ambiguous way – in language. These things are all unavoidable, that is, if you want to be a part of society, and yet it often feels as if these ubiquitous arenas are booby-trapped, rigged in a way that makes participating fully – happily – in society and making use of what should be universal services very difficult for most trans or non-binary people, even impossible for some.

In “The Construction of Transgender Identities through Legal and Self Perspectives”, Kimberley Tao describes how the law, for ease of implementation, naturally seeks to divide human beings into clear-cut categories. Except the categories of male and female don’t actually represent the lived experience of many trans and non-binary people, meaning that in legal settings trans people are seen as “problematic”, even “monstrous”, because of the way significant legal questions become murky and uncertain when they collide with the variety of transgender identities and experience. Further expanding on this idea, “The Significance of Naming Harm for Transwomen: Defining Rape in Aotearoa New Zealand” examines a specific and extremely troubling example of how the law can fail to keep up with its trans or non-binary citizens. In this piece, the authors explain how, according to New Zealand legal definition, it is impossible for a pre-operative transwoman to be raped.

In “Towards A Model of Informed Consent: Trans Healthcare in Aotearoa New Zealand”, the authors detail how trans people are often forced into the uncomfortable position of educating the health professionals whom they are consulting. Many general practitioners (GPs) are completely ignorant of the route that would lead a patient to eventually being prescribed hormones, meaning that they can provide incorrect information to their patients, or are unwilling to act as a gatekeeper in a process they know little about. In terms of surgery in New Zealand, qualified surgeons are few and far between, and there is a 30-year (!) waitlist for some procedures. In addition, the medical system forces those who might identify as whakawahine or fa’afine to adhere to a strictly western narrative of transition, regardless of whether this describes their own experience.

My own, relatively painless, experience of the New Zealand medical system has definitely involved some hiccups. In Wellington, Dunedin and Invercargill, I have been required to educate health professionals about what being trans means, I have had GPs who refused to use male pronouns on my referral letters. I have been required to undergo months of counselling which I did not want and was not in need of. I was refused an appointment with a psychiatrist who claimed my standard request for a referral letter to be beyond his capabilities. I was told by one doctor that my girlfriend must be an “amazing person” for dating someone like me. There was one particularly memorable moment, at a student health clinic in Invercargill, where, after I had explained that I was trans to the nurse, she looked pityingly at me, her face collapsing in misplaced sympathy, and said: “Oh, it’s a terrible, terrible thing.” Largely, I have been able to laugh these things off. A thick skin, patience, and a sense of humour have been essential to starting hormone therapy in New Zealand. As for surgery, funding your own surgery overseas, or being funded by family and friends, is often what trans people who want these procedures resort to. Or they might end up never getting surgery at all. But, my god, it really shouldn’t be this hard.

That is mostly what I leave this collection of essays with: a sense of exasperation. If smart people are writing about these issues in an academic text, we are at the point, culturally, where our institutions need to start listening. This collection shows we have the data, the stories, yet there is still a major – and destructive – lag between how our medical and legal establishments perceive trans people, and how trans people perceive themselves. This is something we can fix but it needs to happen quickly. In fact, it needs to happen now.

Sylvan Thomson writes short stories and non-fiction; he is currently completing an MFA in fiction at the Helen Zell Writers’ Programme, University of Michigan.

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Posted in Non-fiction, Review, Sociology
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