i’ve been talking about this for many years now (here, here, here, and even here – rejection emails not included).

but here we go again:

the main structuring fact of so-called trans healthcare is that the exact doctors who trans liberals hold up as “the best” (cohen-kettenis, for instance) have decades-long collaborative relationships with the exact doctors who trans liberals hold up as “the worst” (zucker, for instance). those two, for example, regularly co-author academic and clinical papers, textbook chapters, and such, and have for as long as they’ve been working in the field.

and what these supposedly “good” doctors’ practice (always remember: practice is purpose), especially when it comes to young people, is the same old gatekeeping with shiny liberal rhetoric. wanna get a trans clinic to question whether you should be there? all you need to do is let them find out you’re wearing a kind of underwear that’s marketed to your originally assigned gender group! (this recent example taken from one of the “best” clinics in the u.s.)

everything the “best” doctors do functions to constrict the range of possibilities available to trans and potentially trans people – especially young people – into a narrow path (a narroWPATH, at best) defined by their priorities, desires, and fantasies about who we should be allowed to be. which are guided by the fundamental beliefs they share with the “worst” doctors: that (despite all evidence) being trans is an innate, essential, biological trait, and that their primary job is to determine who possesses it and “genuinely is” trans, so that they know whether to push them into a train car on the cis or trans track to womanhood or manhood. (those shared articles of faith are why “anti-trans” zucker spent years as the single most prolific person referring kids to “pro-trans” transition clinics.)

and that reinforces – again, especially for young people – steadily increasing constraints on what’s imaginable as a future trans life.

which is to say: all of the doctors are an integral part of the attack on all of us who want to live trans lives with full control over the shape of our futures, right alongside the folks attacking us from the legislative, judicial, paramilitary, and religious sectors.

and this is just as true of every trans person who talks about being trans as if it were – or ever could be – centered on, defined by, or legitimized through the medical system or (desire for / choices about / access to) medical procedures.

yes, i am talking about your very nice friends. some of them are also my very nice friends.

endorsing any form of gatekeeping, endorsing any role for credentialed “experts” in access to any aspect of living a trans life, supports the forces that are attacking us. it says that someone besides us ourselves should be allowed to control our bodies.

it’s not surprising that the core constituency of the trans liberalism that claims that submitting our bodies and lives to the whims of the whitecoats is liberation, not the very definition of subjection, is trans folks deeply committed to differentiating themselves (and those who’ve made the same decisions as theirs about what kinds of surgeries to have or to want) from other trans folks. and, in particular, from trans folks whose choices result in bodies and lives that look less like white professional cis people’s bodies and lives (and, along the way, from folks who face material barriers to having bodies and lives that look like white professional cis people).

it’s not surprising, but it is really fucking weird. if you’ve had a ton of surgery, you oughta know that the entire medical system is our enemy, and that all doctors are gatekeepers (sure, they’re nicer ones if you want what they want you to want, but they’re still the ones holding the keys, still the ones who can cut you off if you’re not sufficiently grateful). and if you want a ton of surgery, you oughta know that just from figuring out how to get it.

but assimilation is a powerful drug! it promises safety so hard that a person could believe they’d get at least a taste, even if they know it’ll never deliver.

and maybe if your actual conditions of life – a graduate degree, a professional job, a face that gets you read as cis, a strong identification with one of the cis genders – are more like those of a cis specialist doctor than they are like most trans folks, you just stop seeing the locks on the door you stepped through. maybe you aren’t paying much attention to what’s behind you, to who they close the door for, as you brunch, picnic, call an uber, hit the beach, go to a friend’s art opening, find a new apartment, worry about the next nightmare court decision, canvass for a progressive candidate whose betrayals you’ll have to explain away.

but let’s be clear.

all the doctors are friends.

they are each other’s friends, not our friends.

all the doctors are our enemies, even the ones we like.

they will remain our enemies until they have no control over how we shape our bodies and lives.

and trans people who legitimize the idea that anyone besides us ourselves should have any say whatsoever in how we shape our trans bodies and lives are helping them.