In Things Trans* People Have Been Saying

[Content Note: Transphobia; self-harm; depression; cis gatekeeping; hostility to agency.]

Because listening to marginalized people speak about their own lived experiences is never considered good enough "evidence" on its own (although it should be), now we have a study confirming what trans* people have been saying about their own lives for many, many years:

A new study has found that when transgender young people are allowed to fully identify with their gender and take steps toward transition, it significantly improves their depression and anxiety.

Forty-two patients participated in the study through Rady Children's Hospital in San Diego, California. Of those, 26 had depression, anxiety, and/or a history of self-harm, and 11 had other psychiatric or behavioral problems, like ADHD, Asperger's syndrome/autism spectrum disorder, and bipolar disorder. According to lead research Maja Marinkovic, many of the patients had suffered greatly from "bullying, discrimination, isolation, and lack of support or lack of insurance coverage for the necessary treatment."

Patients began puberty blockers at an average age of 12.5 years, and then hormone therapy at an average age of 16.5. Two female-to-male patients also had their breasts surgically removed at ages 16 and 18, but others wishing to do the same couldn't because their insurance plans did not cover it or they couldn't find an experienced local surgeon.

In all but two of the patients, depression, anxiety, and self-harm improved, and according to Marinkovic, none of the patients expressed regret or stopped therapy. She worries that families and school staff might not think to have a child assessed for gender dysphoria until they're already showing signs of depression or suicidal ideation. These results suggest that affirming their identities earlier could help prevent their mental health from ever deteriorating that far.

This study adds to the growing research showing that affirming transgender identities at a young age yields positive results.

AND TO THE VOICES OF ALL THE MANY TRANS* PEOPLE WHO HAVE BEEN SAYING THIS OVER AND OVER, while cis gatekeepers continue to deny them access to early and affordable healthcare, and continue to treat transitioning (whatever that looks like for any one individual trans* person) as some sort of "special" medical outlier, instead of the basic healthcare that any trans* person needs.

Also: If you pay attention even a little to the justifications cis gatekeepers use for refusing to provide medical interventions to trans* people, you will have heard the old "oh noes what if they change their minds tho?" canard with regularly. And it's garbage. It's made-up concern trolling used to justify transphobic resentments about paying for other people's healthcare that doesn't look like healthcare the privileged population needs.

Cis gatekeepers will insist that they are genuinely concerned (of course they are) about the hypothetical straw trans* person who changes their mind and then gets all mad about being allowed to have agency. Okay. Fine. Let's take that at face value, for shits and grins. Then I have a perfect solution to that imaginary problem: Let trans* people be the gatekeepers of trans* care.

There, cis people. Now you can wash your hands of your terrible worry.

No takers? Huh.

That's just an unworkable solution, for reasons no one can articulate. Or, more honestly, won't articulate. Because it would mean admitting that withholding early and accessible and routine care is not actually about compassion for trans* people at all.