What we do and who we are

I write this a few days after the sustained US and Israeli strikes began on Iran, fearing that this will take us further towards (or perhaps further into) World War III.  History will tell and judge, and the polemical bonfire and sparks are like to blaze and spit for a long time.

This article is however about another polemical subject, one of the most pronounced now: how we treat and judge transgender people.  This touches our identity and core beliefs and has increasingly been reduced to simple soundbites without appreciating the various and at times contrasting angles.

Gender dysphoria has been formally recognized since 2013 but medical and psychological views have evolved on the issue for the last 50-70 years.  An estimated 0.5%-1% of adults in the USA, with significantly higher rates (up to 5%) among younger generations.

The current US Administration – echoed by governments and political movements in parts of Eastern Europe, Russia, and some other conservative states elsewhere – has generally framed transgender issues through the lens of biological sex as fixed at birth, prioritizing what it describes as “women’s rights”, parental authority, religious freedom and military readiness.  They argue that this protects fairness (e.g. in sports, where a person who has grown up beyond puberty as a biological male will have an unfair physical advantage in size and muscle development compared to biological female), safeguard children and women, and preserve institutional clarity.  For example, there have been cases where transwomen with penises who are prisoners have been moved to female prisons and raped other women, or simply cases where women in changing rooms and toilets feel uncomfortable or that their space is invaded.  ‘Gender-critical’ feminists tend to lead such critiques, sometimes claiming that this can represent a twisted continuation of male and patriarchal dominance.

Conversely, those supportive of trans rights suggest that such policies and approaches may undermine civil rights, medical autonomy, and the safety and dignity of transgender people.  The United Nations (UNAIDS) held a thematic session on reducing health inequalities for transgender people in June 2023.  Studies estimate that transgender people, particularly transwomen, are 13 to 66 times more likely to be HIV-positive (the global average prevalence is 19-20%), given their specific vulnerabilities and situation: many may be sex workers, have unprotected (including anal) sex, and/or inject drugs.  This is exacerbated by poverty and stigma and discrimination.  Their condition may be aggravated by the latter, meaning that through fear of scorn, abuse, rape or worse they are a lot less likely to seek healthcare or HIV prevention.  There are multiple HIV epidemics but that among transgender people represents one of the most extreme.