Marisa

They know they may be sent to psychotherapy, denied HRT, or judged illegitimate if they report wanting to transition for psychosocial reasons.

There is strong pressure for trans people to accept and endorse a biological-medical framing for their transitions.

But adopting this framing carries downsides.

There's a list of bullet points here.

Dependence on medical authorities for legitimacy.

Historically, medicine has treated us very poorly.

We have little power to negotiate for better medical care if we are dependent on medicine to validate us to the rest of society.

Psychological costs.

Trans-cultural memory of medical mistreatment.

Many find medicalization demeaning and resent dependence.

Possible medical eradication.

We can't claim we need care if we don't suffer, but one day the medical system might find a more direct way to eliminate our suffering.

Preventing trans people from coming into existence in the first place.

That's the end of the list.

This is the double bind.

Many trans people need medical treatment, but find the psychological threat of medicalization and eradication intolerable.

Consequently, they will not claim their transition is justified because of biology.

However, they know that psychological and social justifications will also not be accepted.

In this situation, platitudes like I am a woman because I identify as one are a predictable response to incentives.

If you attempt to give a real answer, it will be used against you.