Gender identity is a tricky subject. Many people (I'm led to believe) have an innate sense of gender which may be in harmony or at odds with their physical sex. Not having such a sense myself I'm unable to imagine what that is like and must simply take it on trust that it is indeed a thing, in much the same way that a person blind from birth must simply accept that colours exist and the sky is blue – you say it and I accept that it is so, but it doesn't really mean anything to me.
This makes approaching the issue of transgenderism rather perplexing, and it's an issue that's already complex, controversial, and poorly understood. This is exemplified in the responses to the recent dismissal of Dr Ken Zucker from his position as head of the Gender Identity Clinic at Toronto's Centre for Addiction and Mental Health. “In the transgender community, Dr. Zucker’s dismissal was celebrated” but others argued that his detractors simply had “a flawed understanding of science” (Anderssen 2016).
Zucker's view was that “if one can find a way to live happily inside the boy-girl boxes that biology and culture have designed” (Anderssen 2016) then that would be the best option. This type of view has been criticised as being unreasonably restrictive and “[promoting] the creation of norm-abiding gendered subjects” (Spade 2006: 316), in effect requiring a far greater degree of gender-role conformity of transgender people than of “normal” people; “The 'successful' daily performance of normative gender is a requirement for receiving authorization for body alteration” (Spade 2006: 319).
The use of the term “body alteration” here raises an interesting point and suggests a different way of looking at the issue; though the idea of being the “wrong gender” is an alien concept to me, body modification is something I can understand. Although I have no tattoos or piercings myself, I do not regard those who do as being fundamentally different from me; I wear clothes and style my hair in order to change my appearance, to present myself in a certain way. Body modification is surely no different, other than being seen as more extreme (and less reversible).
“Tattooing as a mode of self-expression … is conceived as both political and liberatory” (Sullivan 2009: 130). We see tattoos as a way to defy convention and make a statement about one's identity; “tattooed bodies … '[subvert] proscribed physicality' (rather than reproducing gendered beauty norms)” (Sullivan 2009: 130). When we see a person with tattoos, we don't assume that they are trying to fit into some normalised category. We accept, without even thinking about it, that that person has chosen to modify their body in order to step outside of such categories.
But it seems there is a somewhat arbitrary distinction between different body modification practices. If a person wishes to make themself look like a lizard – tattooed scales, a forked tongue, etc. – then they are allowed to pay to have that done. We may think them strange, they may find themself the subject of prejudice and discrimination, but no laws exist to stop them and they will not be considered mentally ill on the basis of that alone.
On the other hand, if a female-bodied person wishes to undergo body modification to give themself the appearance of a male body, they must first convince a psychiatrist that they conform sufficiently to male gender norms. The tattooed individual does not have to first live as a lizard to prove their commitment, and that is no less extreme a change.
But all forms of “extreme” body modification are often seen as the same in one important way; as a way to make the external body conform to the internal self. Although it is not as heavily regulated (as it is considered less invasive and risky), tattooing is often seen as a sign of mental illness, or at least instability or deviancy, and this is the same assumption that leads to the stringent restrictions on gender reassignment surgery.
What it comes down to is the idea that the inner person is the true person, the body is merely a vessel for that person, a suit you wear. Your body is property and can be altered or fixed, and “the possibility of fixing renders inescapable the question of whether or not to fix” (Frank 2004: 18). And that forces us to determine whether the owner of the body is right about the need for repairs – is the body really broken, or are they wrong? Are they really fixing it, or are they actually breaking it? Clearly if the body can be in need of repair then there must be a right answer to this question and any other answer is wrong. If the battery cover falls off an electronic device then it can be fixed by taping it on – removing it entirely is not fixing it. There is a right way for the device to be and a “fix” brings it as close to that state as possible.
But if we regard the body and the person as the same thing then we see body modification as self-determination, and that is something that we are generally in favour of. I can choose what to make of myself, I can choose how I want to live my life, what work I do, what hobbies I engage in. I can sculpt my mind (to the best of my ability) in any direction I choose. But as long as my body is seen as being an object separate to myself then there can be rules about what I am allowed to do to it, just as there are rules about what modifications I can make to my house, my car, etc. It's not OK to tell me what I can or cannot be, but rules concerning the use and misuse of property are common.
But even if we regard the body as property, why should we be so concerned with what others choose to do with their property? The issue becomes clear if we look at the case of children. “Children are often considered too young to be informed” and therefore need to have decisions made on their behalf, and many children who have “surgeries … to correct differences in genitalia” go on to “feel mutilated” (Frank 2004: 24). So the fear exists that any such permanent decision made by a child could lead to a lifetime of regret. So the tendency exists to deny them the opportunity to make such a mistake.
This argument seems reasonable, and may be defensible if it applied only to children, but there are other categories of people whom we regard as being incapable of making responsible decisions – women, criminals, deviants and the mentally ill, for example. And if a desire to modify one's body makes one deviant (and possibly mentally ill) then we find ourselves in a Catch-22 situation; If you want to modify your body then you must be deviant, and if you're deviant then you cannot be allowed to modify your body.
The argument is that these desires are the “result of … the occupation of despised social status” (Jeffreys 2000: 410) and are therefore not freely chosen. Like children, those who seek to modify their bodies lack the understanding required to have full agency. While it is fine to allow them to fix their bodies to conform with the standards of normalcy as understood by reasonable, rational people – which is to say, heterosexual, cisgender men – it would be irresponsible to allow them to make a permanent decision which they may come to regret.
And so we return to Dr Zucker. His preference was (according to his critics) to push children to embrace the gender roles of their physical sex. He was criticised “for being slow in referring teenaged patients to hormone therapy” (Anderssen 2016). If we agree with the premise that these patients were too young to properly understand the consequences of their decisions and needed to be protected from themselves then we might be inclined to side with Dr Zucker. But put into the wider context it begins to look less cut and dried.
When we see how difficult it can be for grown adults to get access to such forms of body modification, can we really trust that doctors like Ken Zucker are really protecting their patients? Or are they simply enforcing their own ideas about what a body should be and what constitutes fixing it? At what point does an individual gain the right to determine for themself what they do with their own body – their own self? Why should someone else's idea of who you should be count for more than your own?
Anderssen, Erin (2016), “Gender identity debate swirls over CAMH psychologist, transgender program”, The Globe and Mail, 14 February, http://www.theglobeandmail.com/news/toronto/gender-identity-debate-swirls-over-camh-psychologist-transgender-program/article28758828/, Accessed 15 February 2016.
Frank, Arthur W (2004), “Emily’s Scars: Surgical Shaping, Technoluxe, and Bioethics”, in Hasting’s Centre Report, 34 (2) Mar 2004: 18-29.
Jeffreys, Sheila (2000), “'Body Art' and Social Status: Cutting, Tattooing, and Piercing from a Feminist Perspective” in Feminism and Psychology 10 (4) Nov 2000: 209-429.
Spade, Dean (2006), “Mutilating Gender”, pp. 315-332 in S. Stryker and S. Whittle (eds) The Transgender Studies Reader. New York: Routledge.
Sullivan, Nikki (2009), “The Somatechnics of Bodily Inscription: Tattooing” in Studies in Gender and Sexuality 10 (3) Jun 2009: 129-141.