Evan Urquhart

I mean, really, everything we can conceive of arises from a combination of innate and social, because we can't conceive outside of our social context.

So, throat clearing over: I think gender dysphoria, specifically, is more fruitfully thought of as a medical/scientific phenomenon than a socially constructed one.

What do I mean by gender dysphoria? I'll define it as: Any discomfort with one's birth assigned sex severe enough to prompt a person to consider significant medical and/or social risks that can be substantially alleviated by those risky measures.

It's not a perfect definition. I know.

Now, a small digression- gender dysphoria isn't necessary to transition, or to be trans, or be valid. If gender dysphoria did not exist at all, I'd be all for people changing genders whenever and however much they wanted as a matter of freedom, autonomy.

For most trans people, now and historically, a framework of choice doesn't quite fit. Choice doesn't quite fit the intensity of desire to change genders, the pain and failure of trying to force oneself to conform, the lengths people go to to transition, the risks they take.

Now, saying it's not a choice to be trans doesn't prove it's not a social phenomenon. It's not a choice to have been raised Catholic like my parents, or Unitarian Universalist like myself, but each has had profound and indelible effects.

But, we do know that people living as a gender other than their assigned sex is not a product of our specific culture. Something like it exists, in recognizable but culturally different forms, just about anywhere you look historically and today.

An aside: You might have noticed that I'm not talking about the binary or separating binary trans people out much. One area where my thinking has changed is that I've come to see the binary/NB division as much less salient than I'd thought.

Cultural and historical evidence suggests that people living as the opposite binary sex happens widely, that having some people outside of the binary happens widely, and I doubt it's possible to draw very strict lines around those two groups.

Anyway- the point about finding something like trans people in other cultures and in historical cultures, is that this is not what we expect to see in a primarily social phenomenon.

We also wouldn't necessarily expect medical transition to work as well as it does in a primarily social phenomenon, and we wouldn't expect people who transitioned to mostly stay transitioned and not want to change back.

Incidentally, this is why TERFs (OG TERFs- who knows about the newer, right-wing infected variety) believe so strongly in regret and detransition. If their theory was correct, and this was a purely social phenomenon, that's what you'd expect- lots of regret and detransition.

OK. So, I'm saying that gender dysphoria is probably not, primarily, a social phenomenon. What's left is some kind of biological/medical explanation. This does not necessarily mean it's innate, but if it wasn't innate we'd need a mechanism.

I'm pretty sure we'd know if being transgender was a communicable disease.

It *could* be some sort of environmental toxin... It would have to be something that pre-dates modernity... is all over the world... eh, but even then you'd probably have to bring in an innate susceptibility to explain why it's so rare but also so widespread.

Basically, as someone who believes in physical reality and scientific ways of knowing, it's hard not to conclude that an innate physical condition relating to gender dysphoria/discomfort gives rise to the social phenomenon that, in our culture, we call "being transgender".

And, while I won't go into the evidence on this already long thread, it's perhaps even harder to dismiss the fact that medical interventions are useful and successful for a large number of people who experience gender dysphoria, and that these people rarely experience regret.

Buying into a scientific/medical framework has strengths and drawbacks. It's not the only useful way to think about or talk about these questions.

But, in my opinion, it is one of a few useful ways. It's drawbacks shouldn't overshadow its strengths. Medical transition is a gift, and those of us who pursue it need and in fact DESERVE real research, with rigorous standards, to get the best outcomes.