“What is worrying is when people say that if children don’t get these drugs, they will die, because clearly that’s not true,” Hilary Cass told The Times on December 14th. “It was ‘irresponsible for people to shroud-wave in that way.’”
Cass is widely reviled for her role as architect of the Cass Review — a government inquiry into children and youth gender services in the UK, which has been decried by activists and widely disputed by international authorities for its political bias and methodological failings. The Cass Review has been used as justification for this week’s permanent ban on puberty blockers for trans youth, though these same drugs will continue to be used in apparent safety for cis youth without change. It also appears to be the root cause of the sudden wave of trans adults having their hormones terminated by their GPs, though the Review itself never made such a recommendation. For her work removing access to healthcare for the microscopic minority of trans young people who not only qualified but had made it through years of backlogged NHS waiting lists, she was rewarded with a lifetime peerage, putting her into the House of Lords (a position that will pay her £361 a day of taxpayer money, plus travel and expenses, for each day she attends the House, for the rest of her life).
This cluck-clucking about “shroud-waving” is an increasingly common argument amongst gender critical activists, journalists, and politicians. Like Cass, they believe it’s irresponsible to claim that trans people are at heightened risk for death by suicide. They became so incensed about these claims that the government provided a small inquiry this year to attempt to prove that since the Cass Review there has been no uptick in suicidality among trans kids — they now quietly admit (through FOIA request) that some trans kids’ suicides had been excluded from the results, but let’s not let that get in anybody’s way. How dare we bring up our proximity to death?
The spectre of the trans death, particularly through suicide, hangs over all of the attacks on trans life. No one wants to admit that this is the desired end goal — that trans people simply cease to exist, whether that be through detransition or death seems to matter little. As Janice Raymond famously put it, the goal is for trans people to be “morally mandated out of existence.” Indeed, “shroud waving” threatens to stir up some empathy for the plight of this embattled minority, and we can’t be having that. Anti-trans actors have gone so far as to accuse trans people of acting like abusive husbands who threaten to kill themselves if their wives leave.
It’s a useful strategy, this attack on the idea of trans death, because most cis people will never know a living trans person, let alone a dead one.
This morning, my boyfriend and I sat at the breakfast table. He was putting butter and lavender honey on bread, and I was stealing it — no, I don’t need my own bread, I only want a bite. Revenge for his bites of my dessert last night. As I sent him off into the world, I opened up Instagram and her face was staring back at me. I almost tapped away, not fully taking in the birth and death dates below her picture. At first I thought I was confused about who she was — I always ran into her with her hair up, in the picture it’s down. Then as I wandered around my house, staring at my phone, I kept thinking “but I just saw her the other day.” Time has recently become a little difficult for me, I’m often slightly unsure of how many yesterdays stretch out between me and a moment, so maybe it was the other week. Two weeks ago? I saw her at the little screening of our film Framing Agnes in Peckham, and before that at the CliniQ conference, and before that at the Transforming Futures launch event, and before that…
When confronted with death, we often makes these useless little equations. I saw this person X times, X days-weeks-months ago. They don’t add up to “and so they cannot be dead,” but we must hope somehow that they will. It’s a familiar arithmetic.
In a period of 6 years in my 20s, I attended 15 funerals and only two weddings. For a while, it felt like the sky was falling. Every couple of weeks I would be jostled into awareness that someone who had been standing right beside me, or off just a ways down the street, had disappeared. Looking back from my late 30s, it’s no wonder that I was so chaotic in those years, propelled through the world with a pervasive anxiety. During that time, I lost my boyfriend, several of my closest friends, and saw the deaths of an endless parade of community members, acquaintances, enemies. There were more funerals than I could get to, and quite a few who didn’t have services at all. Some merely bulbs that burnt out, never to be replaced. The vast majority of these people were trans, most died by their own hand, some by murder, others by neglect.
This might not be the trans experience for everyone, but the community I find myself in has always been made up of people living close to the edge — transsexuals, sex workers, drug users. Society’s run aways and throw aways. It sometimes feels like death stalks our lives. Many of us have been rejected by our families, struggled to maintain jobs or housing, subject to violence and abuse, and been plagued by the mental health issues that result. Add to that the overwhelming hopelessness of our time as society runs full tilt towards climate collapse, fascism, and 10 new ways to do austerity — it’s a wonder any of us survive at all.
I can’t say we were friends, more acquaintances than anything, faces seen around in the same spaces over and over, but I admired her. Her life’s work was dedicated to creating domestic violence services for trans survivors — a group of people broadly shut out of VAWG services in the UK — and helping trans people find housing. When we lose such tentpoles of community, I feel not only their individual loss but I wonder how long the centre will hold.
Would puberty blockers have saved all of these people? No, not by themselves. Indeed, most trans teens do not need them, they would be better served getting directly onto cross-sex hormones.1 But the handwringing and legislative attacks on puberty blockers aren’t really about this one medication at all. They are aimed at the very possibility of trans life, an attempt to cut off transness at its root.
Through all of the media and political bluster surrounding trans children, no one ever bothers to ask those of us who were trans children and are now adults what we think. Some few trans adults make it into these so-called debates, but there can a confusion of terms here. While all trans adults were once children, most of us did not transition as children. Some don’t even believe that this was possible more than a decade ago. However, I did.2
Viviane Namaste writes about the autobiographical imperative, the force exerted on trans people to constantly give an account of ourselves. Ever since I first encountered this concept, I have resisted. I do not want to use my personal story, because I believe that I have a lot more to give — as a writer, an artist, and a person — than the mere facts of my life to satisfy the morbid curiosity of the world at large. But more and more, I feel silenced by the way people — both cis and trans — talk about kids who transition without actually speaking to us.
I transitioned as a teenager in the early 2000s after several years of living an increasingly gender non-conforming existence. Thanks to a series of lucky breaks, I made it into an informed consent clinic and was put on hormones at 16. I later had surgery at 19. It may sound too typical or pat for me to say that this treatment saved my life, but indeed it kept my head above water and propelled me out of a series of life-threatening negative coping mechanisms I’d taken up in response to the overwhelming suffering I was experiencing nearly every moment of every day.
During this time, there were not a lot of trans teens running around, but I knew a few both online and in person. Most had no access to medical help, no support from their families. Quite a few were regularly sent away to mental hospitals, disappearing from their livejournals for weeks at a time to be poked at and prodded by psychologists, doped up with yet another antipsychotic or antidepressant. It was preferable to pump them full of these chemicals than to allow them to wear the clothes that they want or even — shock, horror — get sex changes. Nearly all of them are now dead or missing. Sometimes I look them up. At 37, I’ve been starting to forget some of their names.
A smaller group of us, by hook or by crook, managed to get the healthcare we wanted. It didn’t erase all of our struggles, bestowing perfect mental health and skin radiant with the satisfaction of a life well lived. But of that cohort, nearly all of them are still alive. Many of us are still friends.
Do I think medication alone made the difference? I’m not sure it’s that simple. But I know that if I hadn’t had it, my body would be an even more dangerous battlefield to navigate. And that having access to what I knew I wanted, and support — albeit at times missing — from my mother and friends and doctor allowed me to image a life worth living.
I feel the absences of the disappeared. Even as some become nameless, the edges of their shrouds sometimes still brush against my skin.
“You know, for me trans history is a spiritual vocation,” I tell Eliza as we make our way through a University building towards a drinks reception that does not exist. For the past decade my work has largely focused on trans history. Though I am not an academic, I am a relentless researcher and storyteller. From my podcasts One From the Vaults and Harsh Reality: the Miriam Rivera Story, to Framing Agnes and our book Boys Don’t Cry, I’ve made a niche for myself in raising the dead.
All around the world, in nearly every culture and throughout history, people have venerated their ancestors by passing on their names and telling their stories. What is remembered lives, the adage goes. I experience this viscerally. Having spent much of my life mourning the loss of vibrant friends, mentors, community members, and even enemies, it’s no wonder why I have dedicated myself to a practice of ancestral veneration. Nearly all of my friends are dead, but in me their stories live.
Anti-trans pundits and politicians want to invite you into their own callousness. To not feel, to not see, to not hear. Reframing our very real proximity to death as a fit of manipulative hysteria is one way to inure the public to our pain and ultimately make our destruction seem not only possible but necessary.
I would like to believe that if the bones of the dead rattle loudly enough, this could be prevented. But lately I feel myself give in to a growing realisation that people in the dominant culture simply do not care. They need not be specially invited into callousness because they already live there. Each day we watch the death toll of children in Gaza, and a great many other places, climb and climb — yet almost no one does anything to stop it. Our rivers and streams have become so polluted they now carry warning signs while the executives in charge still cash lavish bonus cheques each year. Oh, is Russian state media threatening to drop a nuclear bomb on London again? Just another Monday.
Mariame Kaba famously says that hope is a discipline — one that I fear I am becoming out of shape with. I wonder now less about how we will get out of this, and more who will we be when it ends? And who will be left?
Most of the clinicians I’ve spoken to about puberty blockers over the past decade have, in one or another, related to me that puberty blockers are often more about buying time for *parents* to get comfortable with their childrens’ transitions.
Transitioning as a child does not make anyone better, realer, “more valid,” etc. It is simply a difference in experience. A difference that I experience as vast at times.