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Notes
1 Even though the topic of trans embodiment and experience has been engaged by psychoanalysts for over two decades, in some corners of the analytic world it is still treated as a novelty, and I often meet analysts who seem unaware that we have an established body of scholarship on this topic that they can consult.
2 In brief, I mean two things by this: first, that the term trans has been changing to include more genders and differently experienced/embodied ones. But also, and more importantly, I mean that the dimension of temporality – which is always baked into subjectivity – is especially important in trans experience.
3 We rarely consider, but should, that cis patients also benefit from such explorations regarding their gender development. For many such patients, the assumption of binary gender may have prematurely foreclosed aspects of psychic experience.
4 Not all analysts who are trans are (or feel they can afford to be) out about their gender. It is hard to be out when psychoanalysis can be so invalidating as to trans experience. This has had an alienating effect on trans individuals who may want to train as analysts. Of those analysts who are trans, out and have been publishing on this topic, I would direct the reader to work by Griffin Hansbury and Jack Pula. Notably, and as far as I know, we have no published work yet by an out trans female analyst, though I am aware of at least one out trans female candidate currently in training in an IPA institute.
5 A term that denotes persons whose gender identity corresponds to their birth sex. I am not myself fond of the term cis for various reasons but use it as a shorthand here to differentiate from trans.
6 See Corbett (Citation1997) for the emergence of the speaking queer subject and Powell (Citation2018) for a similar point regarding analysts of colour.
7 The fiction that cis analysts are objective outsiders immune from subjective thoughts, biases and emotions is problematic – and a political position often not recognized as such.
8 https://www.youtube.com/watch?v=vqNJbZR_QZ4; the quote is my translation.
9 Corbett’s concept of regulatory anxiety is relevant here, and those working in this area should be familiar with it.
10 A quick online search on “online radicalization” yields results on young people who, having lost their way, are recruited by violent extremist organizations.
11 Although there is certainly a good amount of problematic thinking about trans in the general culture and some domains of mental health, we should not forget here that there has existed, and still does exist, much damaging and transphobic thinking within psychoanalysis as well.
12 More on this shortly, but for now Stryker’s brief statement might help: “Only the delusional would deny biological differences between people, but only the uninformed can maintain that what the body means, and how it relates to social categor[ies], doesn’t vary between cultures and over time.” From https://time.com/5795626/what-womanhood-means/
13 It should be noted that we do not, to my knowledge, have data from psychoanalytic treatments that shows this to be a viable therapeutic aspiration. See Suchet on this point.
14 This may be one reason why queer analysts who may have already negotiated these dynamics and turbulence in themselves (rather than confronting them for the first time in the encounter with a trans person’s body) may have wider berth internally to work with this population.
15 It is easy to self-servingly attribute premature terminations to the patient’s incapacity to tolerate the work – for instance, saying that trans patients are unanalysable. However, analysts experienced with this population find this not to be true.
16 This is not to imply that trans subjects are new iterations of humans: atypical genders have existed throughout history. What has changed is that we have now reached a tipping point that makes trans impossible to dismiss, no longer an anomaly.
17 John Money and Robert Stoller introduced them first, Stoller being the first analyst to discuss the concept of gender identity.
18 Even the notion itself of biological sexual difference as a binary has been contested by biologists, but that’s beyond the point of this essay.
19 Laplanche’s critique of phylogenesis can prove very useful here. Scarfone’s work can also offer helpful paths towards this reworking, especially his ideas regarding how unconscious fantasy, and our theory-building, may themselves be understood as translations.
20 This awkward term, widely used in the world of trans health care and mental health, describes not the child’s gender but how the child’s gender was assigned at birth on the basis of observed genitals. That assignment may, or not, align with later gender identities.
21 Littman did not study the population of trans kids themselves but their parents – a problem, as anyone who has worked with adolescent patients can gather. In addition, the sample was not representative of all parents of trans kids but culled parents from selective websites. For a full discussion of the methodological problems in Littman’s study, see https://medium.com/@juliaserano/everything-you-need-to-know-about-rapid-onset-gender-dysphoria-1940b8afdeba
22 The notion of trans being a trend is how the term “transtrending” first originated.
23 Hormone blocking or hormone suppression is a pharmacologically mediated process that blocks pubertal development. The premise is to delay the onset of puberty and the development of secondary sexual characteristics to “buy time” while the child continues to explore/understand their gender. As analysts we know, of course, that nothing pauses the psychic metronome. Still, the reasoning is to press a pause button before proceeding to cross-sex hormones, which have more irreversible potential – and which are administered years after hormone blocking.
24 Several other important matters cannot be addressed here because of space limitations but I hope we can return to them in my upcoming conversation on this topic with my colleague, David Bell. For example, the fact that we do not have a reliable way of predicting whose gender will persist; that anecdotal evidence, consistent with my own clinical experience, suggests that a very small number of children who go on blockers do not proceed to cross-sex hormones; the fact that discontinuing puberty blockers does not amount, at the very least not psychically, to things picking up from where they were paused; and the complex question of de-transitioning, which can generate much anxiety in the patient, the family and the analyst.
25 As the sociologist Meadow (Citation2018) has argued, trans embodiments do not destroy gender or obliterate gender difference. On the contrary, they articulate gender’s multiple and varied forms with more particularity and precision. As such, trans paradoxically does not destroy but illuminates more shades of gender difference.