November 25, 2018 Brianna Nicole Austin no responses

The Transgender Debate Over Wanting Vs. Needing

The transgender debate over wanting vs. needing has been raging among the medical profession for decades, or longer. Is a patient simply wanting enough, or must there be a need?
There is no question that some transgender folks pursue a transition that is neither realistic nor the source of their happiness.  For large, masculine men, a transition will mean you’re a large, masculine woman, which might not be the life you envisioned. If you’re unhappy in your life and happen to be a cross-dresser to boot, a transition may result in your being an unhappy post-op transsexual.

We all look in the mirror and see different things. Sometimes, it is what we want to see, like that extra curve no one else does, sometimes it is the fantasy that post-transition they will emerge a princess.

Are those grounds for them to be denied pursuing transition? Some people think so. Others see the transition as a ‘want’, like any other want, and shouldn’t be subject to gatekeepers deciding who is qualified to receive it, or not.

The Transgender Debate Over Wanting Vs. Needing

Since the early days, as established in the Standards of Care — as it relates to gender reassignment –, it has always begun with one thing: is the patient truly transgender. Thus, candidates were required to undergo extensive therapy to establish the “truth.” But who’s truth?

Medical professionals contend with their oath: do no harm. However, for them to make that assessment they have to first have an opinion as to what gender dysphoria is — mental, biological, or neurological.

How can anyone not transgender evaluate what is going on within someone who is? That would be like trying to reach out and grab the fog before you.

In an article in The New York Times entitled “My New Vagina Won’t Make Me Happy“, author Andrea Long Chu says that being transgender is like “… unable to get warm, no matter how many layers you put on.  It feels like hunger without an appetite. It feels like getting on an airplane to fly home, only to realize mid-flight this is it: you’re going to spend the rest of your life on an airplane. It feels like grieving. It feels like  having nothing to grieve.”

The torment of the many of us have experienced, as well as breathing that first breath outside it, and the intoxicating profound impact on our consciousness, as I did:

I could hear the heartbeat of life all around me and now touch those emotions that had previously been only for the viewing, protected or trapped behind the glass wall, always in sight, never within reach. Emerging from behind the mask of a life not truly mine, yet inadvertently one of my own design, I stood naked before the world, refreshed and unafraid. I was confronted with the truth of me as only I knew it, while others could only look on with bemused wonderment, concern or disdain.

There is a difference however between that feeling outside the closet and the world that awaits those that continue further down the path to transition.

Ms. Chu noted that her new vagina won’t make her happy, “But I want it.”

Those seeking hormone therapy can usually get it, by maintaining a narrative that they are locked in the wrong body; that they’re miserable and in pain, that only transition will relieve it. I know several people, personally, who duped the system knowingly, only to reverse course when their fantasy was over.

In a well-crafted essay, Ms. Chu delves into these subjects at length.  The big question is who should decide the fate one’s own life?

I’ve always taken the view that when it comes to ones’ trans life, the decisions that are made about hormones, relationship, transition, et al, deep reflection is important in such life-altering decisions. Is simply “wanting” it enough?

Being happy and transitioning are two completely different things: one is not reliant on the other.  Ms. Chu seems to concur while saying that though her vagina in of itself won’t make her happy, a transition can “make an enormous difference in the lives of trans people.”

I’ve never believed that transition, with or without gender reassignment, makes one happy or not. Happiness comes from deeper within, and I truly think that you have to find comfort within yourself, and then pursue transition, not the other way around.

As always, be happy, be safe, and always think pretty!

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Brianna Nicole Austin is an author, writer, columnist and journalist and editor of from New York City, now living abroad.
Brianna Nicole Austin