The Fundamentals of Transphobia

The opposition is very confused about the differences between sex and gender, gender identity and sexual orientation. But the problem is more fundamental: Most Americans do not have a basic understanding of human biology and reflexively equate "biology" and "sex" with genitals.
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This is my first-anniversary blog post on The Huffington Post, and as the month of November begins, I want to take the opportunity to give thanks to the folks at HuffPost and all of you who have taken the time to read my words, and a special thanks to those who've commented, either in writing or in person. It's always a thrill to get feedback, especially when my work is going out around the globe and there is no routine means of follow-up. I very much appreciate people, be they mainstream media editors or community members, and especially parents and friends of LGBT persons, coming up to offer thanks or comments, and it's a pleasure to make new acquaintances that way. I learned the importance, actually the necessity, of follow-up as a physician, and while it's not as critical for a writer, it's still very important. I write to educate, influence and inspire, and I'm very happy to have been able to accomplish so much this past year.

In recent posts I've touched on a current political issue, California's A.B. 1266, the "School Success and Opportunity Act of 2013," which explicitly gives trans students the same rights as all other students. It should be noted that those rights are already part of state law, so this bill simply codifies those protections with language specific to trans students. And it should also be noted that the Los Angeles and San Francisco school systems have had such protections for even longer and have never had a problem.

However, the extreme, conservative, reactionary fringe, having thrown in the towel on gay issues, to a large degree (note the recent Daily Show sketch on attitudes toward homosexuality in Alabama and Mississippi), is now targeting those trans students in California. My friend Zack Ford recently blogged on this issue on ThinkProgress. Yes, the opposition is very confused about the differences between sex and gender, gender identity and sexual orientation, and a lot of other issues as well. But the problem is more fundamental than that, and it is a more general one: Most Americans do not have a basic understanding of human biology and simply, reflexively, equate "biology" and "sex" with genitals.

The U.S. courts use the words "sex" and "gender" interchangeably in legal contexts, but medicine and academia generally use them to distinguish between biology and the psychosocial manifestations of that biology. "Sex" includes the cellular materials that make up the sexual anatomy and physiology of a human being, including:
  • Chromosomes
  • Genes
  • The cellular machinery for controlling the genetic material and its expression as RNA and protein
  • Gonads
  • Genitals
  • Other reproductive organs
  • Hormones
  • Hormone receptors
  • Secondary sexual characteristics, such as breasts and facial hair
  • Brain (the most important factor)

Notice that genitals are only one of the 10 categories, yet when a religious conservative complains about trans women being "biological males," genitals are the only aspect of human sexuality to which they are referring. And because of profound embarrassment relating to human sexuality in all its manifestations, from anatomy to gender presentation and role, and to sexual relationships as well, they are often incapable of being clear to themselves about the source of their discomfort. They are incapable of using the anatomic terms for human genitalia, and that often includes the scientists and physicians among them.

So what, really, is their problem? I believe that there are two basic issues, and they both derive from a sexist, misogynistic worldview that permeates Western civilization to this day. There is a basic fear, and a resultant mistrust, of the modern world, with its evolution from traditional gender roles. Individuals changing gender represent the individual face of the sexes changing their societal roles, and the act of individual gender transition therefore embodies all the anxieties about the shifting roles of men and women in our society. While many people are anxious about this, it is a particularly acute problem for religious fundamentalists, be they Christian, Muslim or Jewish, because those societies are predicated on historically rigid gender attributes and roles.

The second issue relates just to trans women, who are the sole targets of the radical lesbian separatist community as well as the religious right. Trans men get a pass, because they are seen as justified in embracing society's codes of masculinity. Their presence in the men's room rarely comes under attack, and no one, when questioned, ever says that they want a trans man in the women's room. The Transgender Law Center's Masen Davis' interview on MSNBC exemplifies this observable fact beautifully.

With trans women it is a completely different matter. Hate, deriving from the simple act of someone viewed as male switching teams, and exacerbated when that switch includes genital reconstruction of the penis, fuels the portrayal of trans women as male sexual predators intent on committing mayhem in women's spaces. Even the radical lesbians, who base their feminism on their panic deriving from the potential to be forcibly impregnated by men, feed off this male anxiety about those who willingly surrender their male bodies and male privilege. The battle in California today, like that in Phoenix earlier this year, as well as in other cities and counties over the past six years, including my Montgomery County, Md., is wholly dependent on the completely fabricated view of trans women as perverted men. This meme, replicated everywhere from Alfred Hitchcock's Psycho to today's Hit and Miss, has been partially softened in the media only over the past decade. The American medical and scientific communities, now fully on board, have significantly altered the stereotype of the trans woman as a stalking serial killer, at least outside the genre of specialized television drama.

It gets down to a fundamental failure of science education in particular, and of universal moral education in general, which allows our children to grow up believing that sex is a rigid binary, that there are no trans or intersex individuals, and that gender roles were mandated by God to be rigid and under the control of men. Trans women are at the vanguard of the 21st century's liberation of both genders, and they pay a particularly outsized price for that privilege.

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