I know why there has been a massive increase in the number of people seeking help to change their gender.

I haven’t had a very good week – and yes, I do mean that from the morbidly introspective, self-pitying, emotionally hyper-aware viewpoint of the periodically depressed.  I haven’t had a very good week because, from time-to-time, the unfulfillable longing to be beautiful and sexy in a female way, and my irrational regret at never having had a childhood where I twirled in dresses and went to my high-school prom looking like a princess – and the sheer arbitrary cruelty of the fact that I wasn’t born female – all become too much to bear, and I collapse; to paraphrase Emily Dickinson: a plank in reason breaks, and I plunge down and down and down.  When you monitor your relationship with what you want (and with what you cannot have) with an intensity you cannot help when you are prone to depressive episodes, then you know when you haven’t had a very good week: I have been tearful, paralysed by anxiety, unable to communicate the help I need, and – most shamefully – incapable of both giving and receiving compassion from the people who care about me the most.  This month, meanwhile, The Guardian newspaper has published statistics relating to the rise in the number of people being referred to gender identity clinics in the UK.  At first glance, these figures seem startling, but I am unconvinced by the claim that they are due to a burgeoning willingness by Britons to celebrate difference and embrace gender diversity.  I think the number of people seeking help to cope with issues relating to gender identity is collateral damage from a society that celebrates polarised views of what it means to be male or female.  I think contemporary constructions of hyper-sexualised femininity – and of a powerful, alpha-male version of masculinity – are responsible for many people’s experience of an unfulfillable yearning to cross the boundary between the sexes.  I think this situation has served as a perfect incubator for disillusionment, dissatisfaction and depression, and, because it is society that perpetuates these gender caricatures, we must all share responsibility for the people they damage.


In his book ‘The Noonday Demon’ (Vintage, 2002), Andrew Solomon says depression is the mechanism of despair:

“When it comes, it degrades one’s self and ultimately eclipses the capacity to give or receive affection.  It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself.”

In his chapter on breakdowns, Solomon describes the minutes experienced through the lens of depression as being like dog years: depression incapacitates the sufferer; it leaves them frozen – usually in bed – and unable to move, eat, speak, or complete simple daily routines, like showering.  Above all, Solomon observes, depression is preposterous: episodes can occur when your life appears otherwise under control – or even when projects you have undertaken are enjoying a measure of success.  Depression is not irrational, however, and it certainly doesn’t entail an impairment of judgement.  On the contrary, depression puts you “in touch with the real terribleness of your life”:

“When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old.  You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better.  Being upset, even profoundly upset, is a temporal experience, while depression is atemporal.  Breakdowns leave you with no point of view.”

There is a sinister logic to a depressive collapse.  A breakdown is both the cause and consequence of an attempt to confront the nastiest aspects of your life; of a struggle to understand and master the very things with the power to destroy you.  It can be tempting to romanticise depression by believing that that you, and only you, undergo such periods of terrible suffering.  The notion that depression is a nameless monster, which looms out of the shadows of your subconscious when you least expect it, is a spurious one: as I have become more adept at recognising the triggers of my own depressive episodes, I have realised that my bouts of abject wretchedness have a specific cause, and that, in the context of my life as a transgender person, they make perfect sense.

I don’t pretend to that my problems are greater or more distressing than any that other people have, and I have listened patiently to futile attempts to console me out of depressive episodes that urge me to be thankful I don’t have a terminal illness; I’m not in a wheelchair; I wasn’t abused as a child; I am fit and healthy; I have had a good education; I run my own business and have a (reasonably) steady income; I am socially adroit; I am able to manage the everyday affairs of my life (like paying bills and maintaining friendships) easily and efficiently; I’m resilient and resourceful; I’ve travelled quite a bit; and there are people who love me.  The reason these well-intentioned efforts to shame me out of melancholia are so meaningless, however, is that I know all that.  Moreover: I’m smart, charming, and beguiling enough to achieve pretty much whatever I set my mind to.  The root of my depression is that there is one thing which, no matter how hard I work or how optimistic I try to be, I will ultimately remain totally powerless to obtain.  I was not born a girl.  I can dress like one; grow my hair; voice-coach myself to a chalky approximation of how a girl talks; learn to walk, talk and sit like a girl; undergo whatever cosmetic procedures are within my means to appear more superficially girl-like; but – and even to type this is painful – I cannot ever truly be the beautiful, sexy woman I wish I was.

Facing up to the ridiculous futility of my yearning would be, you would think, the first step towards accepting my physical limitations, shrugging off depression, and moving on.  Why can’t I just embrace the things I am good at, and dismiss as a pipe-dream the one thing I can never be?  The reason I can’t wave the desire away and channel my energy into something else is simple: I can never escape the living, breathing reminders of who I want to be; I can’t avoid women.  When I’m feeling particularly vulnerable, the sight or memory of an attractive woman provokes a chillingly physical nervous response – a miniature seizure, of sorts; an involuntary shudder, a tightening of the jaw, a pressure behind my eyes, an itch under my scalp, and a moment a few seconds later when I realise I’ve been pressing my fingernails so hard into the palms of my hands that I’ve left small, crescent-moon shaped bruises there.  All the hallmarks, in other words, of a minor panic attack.

And these panic attacks are not only triggered by skinny models in lingerie.  I’m not a complete idiot: the synthetic constructions of beauty in advertisements, magazines, on television and in pornography are actually easier to deal with than reality, because I know that artificial constructions of femininity are precisely that – artificial.  It is attractiveness in the flesh that I am occasionally completely unable to handle, and there are dozens of women who – because their hair was styled just as I want mine, or because the cut of their dress hung just right on their feminine hips, or because their neck was long and smooth, or because their shoulders were slight, or because they’ve never had to shave their chin, or because they had a trim waist, or because their swimming-costume met in a neat V-shape between their thighs – have inadvertently condemned me to days of bleak depression, curled like a knot in darkness, sobbing for air as if I was drowning.

More recently, the remit of my depressive episodes has expanded, and I now find myself – on top of my more tangible frustration – lamenting a childhood and adolescence I will never be able to experience.  This stirring of an extra little soupçon of sadness into the mix of general desolation is, no doubt, due to the achievement of my fortieth birthday.  Not only must I contend with being a woman without having first undergone the apprenticeship of having been a girl: now, when I wear a My Little Pony tee-shirt (assuming I can find one that fits me), I look neither cute nor ironic; I just look like a bit of a pervert.  More than having missed out on learning how to braid my own hair, or of having friends who could teach me how to put on make-up, I’ve missed out on the rites of passage of the ingénue, and on glorying in public approbation as a debutante: the moments when teams of family and friends help you look beautiful for your prom, pretty you up for your first date, dress you like a film-star for your sixteenth birthday, and ensure you appear stunning at your university graduation.  I hid from these landmark events of my formative years because I couldn’t cope with the feelings of disappointment and envy associated with them.  I was married for a while, too, and I spent the day of the ceremony wishing I was the one who looked like a queen.

Along with a god I don’t really believe in, every woman who has ever lived, and the shoe manufacturers who decree that the sizes of their women’s range should only go up to 41, I increasingly find myself blaming my parents for the girlhood I never had.  Parents – particularly those in the United States – who recognise that their children’s unhappiness may be due to a form of gender dysphoria, and who enable them to explore the world of the boy or girl they want to be, are often subjected to harsh and sustained criticism.  Gender nonconformity is just a phase, their detractors say: so-called transgender children are just experimenting, and can’t possibly make informed decisions about whether they ‘feel’ like a boy or a girl.  She’s a tomboy!  Not all boys like to play with guns or kick a football around!  From that perspective, to impose transition on a child isn’t just irresponsible and misguided; it is tantamount to child abuse.

But I envy those children.  My mother remembers me spending painful hours in floods of tears, telling her that I thought I was ugly, but her response always began and ended with a hug, a warm glass of milk, and the hope that I would feel better after a night’s sleep.  I was never brave enough to tell them that I wanted to be Princess Leia, but I wish my parents had had the whit, the bravery and the imagination to dig more deeply into the reasons for my fits of misery, and it seems to me an act of gross negligence that they didn’t step in to help me defeat my demons long, long before I was old enough to regret that they hadn’t.  When they finally wrung an explanation for my depression out of me years later, they didn’t attempt to repair the damage their neglect had done.  Instead, they swore me to secrecy.  When I experience a breakdown now, I know that one of the reasons I weep is for the hours I wasted daydreaming of an alternative – female – version of me, and on years of self-imposed isolation and profound sartorial disappointment.

Frame Cinderella
Why, oh why, can’t I? – Not everybody gets to be a princess

Using data obtained via a freedom of information request, an article in The Guardian newspaper this week reported that, over the last decade, the number of people being referred by their GP to the gender identity clinic at Charing Cross Hospital in London has quadrupled.  At the same time, the Exeter GIC (which opened in 2006) has seen a twenty-fold increase in referrals.  The number of referrals to the Leeds clinic (which opened its doors in 2009) has tripled.  The GIC in Sheffield had eight referrals in 1998, but 301 in 2015.  At the gender identity clinic that opened in Nottingham in 2008, referrals have risen by a factor of 28.  The Tavistock centre, which specialises in care for transgender children and teenagers, has been experiencing increases of around 50% a year since 2010 – and demand for its services has doubled since 2015.

The received wisdom about this sudden and meteoric increase in the numbers of UK citizens seeking medical and psychiatric help for issues relating to their gender identity is that society has become more accepting of gender nonconformity.  As the public becomes more tolerant of difference, and as transgender people become more visible in the media and in popular culture, the argument goes, there is less reason for those who aren’t satisfied with the gender role dished out to them arbitrarily at birth to remain in the closet.

This line of reasoning has a small flaw, however, which is that it assumes that referrals to UK gender identity clinics, and the numbers of people who are coming-out as transgender in Britain, are synonymous.  Improvements in the United Kingdom’s capacity for tolerance (regardless of whether that should be a source of pride) do not explain why more and more people are identifying with a gender not determined by their chromosomal sex, so it is a fallacy to claim that increased national magnanimity is behind the rise in referrals to the country’s GICs.  On the contrary: referral to the Charing Cross clinic is an indication that something is deeply wrong with a transgender patient; it is a sign that they not coping with the feelings of depression and defeat associated with their gender identity, not proof that they are ready to kick up their heels and celebrate the man or woman they’ve always wanted to be – and it certainly does not constitute evidence of a drift towards more laissez-faire attitudes to gender identity.  Submitting to medical or psychiatric help entails a willingness to pathologise one’s gender identity.  Acquiescing to the interminable waiting-times and institutionalised condescension of the GIC is an act of desperation – the last resort of the powerless; of someone who fears they might be going mad, and has nowhere else to turn.

Frame Graph
Nothing to be proud of – The Guardian newspaper’s guide to referrals to Gender Identity Clinics in the UK (July 2016), for people who need coloured lines to help them appreciate the rising and falling of things

Trans-exclusionary radical feminism (TERF) is not a political or philosophical doctrine as such, and it is certainly not a label feminist thinkers would use to self-identify.  Rather, it is a loose, post hoc category into which a number of articles, speeches and espousals by feminist writers and activists can be placed; a way of describing particular arguments against the right of transwomen to access every sphere of biological, cisgender-female life.  For example, the academic Julie Bindel (who is also co-founder of the English law-reform group, Justice for Women), asserted in a 2004 Guardian article that is was perfectly right and proper that a Vancouver transwoman should be barred from training as a rape counsellor.  Bindel’s argument was that a male-to-female transsexual could never fully understand rape from a woman’s perspective, no matter how well-intentioned they were:

“The arrogance is staggering: having not experienced life as a ‘woman’ until middle age, Nixon assumed ‘she’ would be suitable to counsel women who have chosen to access a service that offers support from women who have suffered similar experiences, not from a man in a dress!  …I don’t have a problem with men disposing of their genitals, but it does not make them women, in the same way that shoving a bit of vacuum hose down your 501s does not make you a man.”

TERF is a pigeonhole for statements which seem to discriminate against transgender people by asserting that feminists have not struggled for decades against the stereotyped enactment of gender roles (“fuck-me shoes and birds’-nest hair for the boys; beards, muscles and tattoos for the girls”, in Bindel’s words), in order for transsexuals to ruin their hard work by attempting to reassert a conception of womanhood that is the product of a male, heterosexual hegemony.  This brand of feminist thought is exclusionary in the sense that it does not consider the transgender voice a valid contribution to feminist discourse and debate: because male-to-female transsexuals embody masculine views of what it means to be a woman, they can only perpetuate traditional and oppressive views of what a woman should look like, and the role they should play in society.  The TERF perspective further argues that it is artificial and reductive to lump transgender people into the same demographic group as gay men and homosexual women.  LGBT has become too messy and contradictory a construct to have political teeth, the TERF argument goes: by attempting to shoulder their way into the shadow of the rainbow flag of gay-activism, transsexuals are undermining the work of changing society’s preconceptions of what it means to be male or female, gay or straight.

In August 2011, meanwhile, Maryland Lawyer, Cathy Brennan, wrote an open letter to the United Nations Commission on Human Rights to challenge the conceptualisations of gender used by the UN on rulings on discrimination.  Brennan’s contention was that “this legislation incorporates stereotypical ideas of ‘what is female’ into law”, and she sought specifically to oppose UN rulings against the exclusion of transgender women from “female-only space… such as female-only clubs, public restrooms, [and] public showers”, on the grounds that “females require sex-segregated facilities for a number of reasons, chief among them the documented frequency of male sexual violence against females”.

As well as granting open access to women’s changing rooms to marauding bands of transsexual rapists, Brennan was concerned that the definition (or, rather, absence of a tangible definition) of ‘gender identity’ in UN legislation in this area served to entrench sexist ideas more deeply into law of what constitutes male and female.  Where notions of gender identity are predicated on the values of self-identification, Brennan maintained, transsexual stereotypes of what constitutes womanhood are permitted to influence how womanhood is constituted by society generally.  In other words, women need to be legally free from the obligation to conform to the brand of femininity embodied by fetish transvestites tottering around in fishnets and stiletto-heels:

“Archaic stereotypes are directly responsible for the denial of female credibility and intellectual authority, in addition to causing the historical marginalisation of females, lower social status vis-à-vis males, and lack of power to engage equally with males.  Even where law has evolved to formally prohibit sex-stereotyping, women continue to suffer from the lingering effects of sexist ideologies of female inferiority.  So although we support every individual’s right to express their ‘gender identity’, it is absolutely critical that law not confuse ‘feminine expression’ with female reproductive capacity of female genital presentation.  We believe that ‘gender identity’ laws that codify the notion that there are traits, manners of expression, or modes of appearance that are inconsistent or consistent with one’s biological sex violates United Nations conventions seeking to eradicate sex stereotyping.”

In a nutshell, the stance of trans-exclusionary radical feminists is that women who seek to become men are motivated by the desire to feel powerful in a world which is politically disposed towards favouring men (in terms of social influence, economic gain, career progression, and so on); whilst male-to-female transsexuals are motivated by nothing more sophisticated than sex – by the desire to recast themselves as sexual beings, according their own fetishized ideas of what constitutes ‘sexiness’.

Frame Awakening
“That’s it!” said Matthew with a squeal of delight, rising to his feet in wonder at his epiphany. “The solution to my fundamental dissatisfaction with my self-image and place in society: I need to become a woman!”

Is my transition motivated by sex?  Of course it is!  What else could it be motivated by?  I live in a social and cultural milieu populated by more than its fair share of sexy, beautiful women.  There are, of course, plenty of men who are also sexy and beautiful, but I cannot help that my desire is to be beautiful and sexy in a way that is typically reserved for females – and, yes, that does mean that I aspire to a version of femininity that is idiosyncratic to me.  I have not formed my ideal of beauty in a vacuum, however: I have constructed it from the clay provided by the world around me, which includes the images of women I see in magazines and on television, and via the doctored un-reality of advertising, as well in the flesh-and-blood, actual living-breathing women I see every day as I go about the business of urban life.  I am not so naïve that I swallow the superficial (and, for most cisgender women, unattainable) version of femininity peddled to me to sell lipstick and yoghurt.  I recognise the misogyny inherent in the starvation required to model clothing or dance ballet, and I’m not stupid enough to think that every woman I see is completely at ease with her own body – everyone feels some degree of pressure to look a certain way, maintain a particular weight, or try and arrest the physical signs of aging.  The version of womanhood I aspire to isn’t solely founded on the synthetic and the unobtainable: I want people to look at me and think, God, she’s fit, in the same way people turn and look at umpteen real-life women in the street every day, and all I ask is to have the same anxieties about myself as a biological woman.  I promise to work as hard as they do to maintain the body I want!  I try not to add the massive head start women have on me to my list of things to obsess over when I’m depressed, but I did not set out on my transgender journey thinking that anyone ever feels completely satisfied with how they look.  I do not assume I’ll one day be able to stop working and say to myself, There: I’ve done it; I now consider myself gorgeous.  Transition is the way I have elected to take concrete steps towards my ambitions.  More importantly, it is the active means via which I can remind myself that I am doing all I can: I do not see transition as an ends itself, but as a lifelong therapeutic process.  Being able to remind myself of that provides a tiny spark of comfort during my darkest hours of despair.

I cannot be the only person who feels this way; it is inconceivable that no-one but me suffers crippling depression because they wish they could find themselves beautiful.  If I were alone, the number of referrals to the UK’s gender identity clinics would not have risen so meteorically over the last ten years.  The important issue, of course, is whether my reasons should be considered sordid, and, if they should, whether that invalidates the legitimacy of my wish that society adjust in order to accept me as one its female members.

Let me put it like this.  Changing gender is an attempt to scratch a maddening itch.  If trans-exclusionary radical feminism is right – and transsexuality is the product of a sexual drive or a desire to feel powerful – then that sexuality and that form of power is a product of the world in which I live.  I want to change gender because I long to occupy a social role – and feel a particular way about myself – that would otherwise be denied me.  I cannot, for example, work as a teacher if I wish to live as a practising transvestite.  In order to be permitted to enter a school looking how, and wearing what, I want, I have to declare myself transgender.  Only by executing a number of administrative duties – such as changing my name – can I wear a dress and still go about my daily business with legal protection from discrimination.  It is necessary, if you like, to stake a formal claim to being transgender in order to gain even a modicum of public permission to dress how I want and still have a chance of being taken seriously.

Gender roles are a product of the societies in which they are enacted.  ‘Male’ and ‘female’ are modes of behaviour codified and institutionalised – and accepted as the norm – in the contexts in which they occur.  I live in a society that isn’t merely hyper-sexualised, but which has polarised its idealised images of masculine and feminine attractiveness.  The metrosexual, androgynous culture of the nineties – which blurred the lines between the genders, and saw make-up and handbags for men on sale in high-street stores – has all but evaporated.  In its place, women are increasingly expected to look and behave one way, and men are expected to look and behave in another.  All I want, through no fault of my own, is a taste of the former.  I am simply unlucky that the biological sex I was assigned at birth, and the upbringing I had, mean that I have to work that bit harder to get it than the large portion of the population who were born women.

From this perspective, my depressive breakdowns result from the norms of feminine beauty to which I cannot help but be exposed.  That exposure has eroded my quality of life, and prompted me to seek a radical solution to my pain.  Society, in short, has made me want to be a woman.  That makes me society’s responsibility, and I’ll be damned if I’m going to let that society tell me I am wrong to ask for its blessing in getting what I want.



The statistics relating to the rise in referrals to UK gender identity clinics, as they were reported by The Guardian in July 2016, can be studied here…https://www.theguardian.com/society/2016/jul/10/transgender-clinic-waiting-times-patient-numbers-soar-gender-identity-services

Julie Bindel’s 2004 trans-exclusionary Guardian article, ‘Gender Benders, Beware’, can be read here…          https://www.theguardian.com/world/2004/jan/31/gender.weekend7

Cathy Brennan’s 2011 letter to the UN challenging non-biological definitions of gender in law, and calling for the protection of female-only spaces, can be enjoyed here…                                                                                                   https://sexnotgender.com/gender-identity-legislation-and-the-erosion-of-sex-based-legal-protections-for-females/

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