Julian Applebaum

As the number of transgender legal cases reaching American courts increases, a growing body of scholarship has begun to examine how judges and institutions struggle to reconcile gender variance in a system with deeply entrenched gender normativity. Scholars have examined how judges become the interpreters of gender when presiding over cases concerning transgender inclusion and civil rights, constructing narratives of what it means to be transgender and codifying it as law. This paper presents a novel systematic analysis of judicial frameworks courts use to adjudicate gender identity. Analyzing 70 court opinions from 1966 to 2022, I examine how judges rhetorically describe gender variance and gender variant people to anchor them within deeply entrenched gender normativity. Updating and recontextualizing past scholarship within the current post-Bostock transgender rights crisis, I present a typology of four categories of judicial interpretation—biological gender essentialism, medicalism, assimilationism, and deferential to the litigant—and note other rhetorical and juridical trends for interpreting gender variance. I argue that the frameworks that most likely lead to a trans litigant’s victory are ones which reify the gender binary and pathologize transgender people, and discuss the problematics of that success.

Original Article

Jules L. Madzia , Tee Chuanromanee , Gaines Blasdel , Aloe DeGuia , Mary Byrnes , Nabeel A. Shakir , Megan Lane , Oliver L. Haimson

Online spaces are increasingly important for transgender people who are considering gender-affirming surgeries to find information, ask questions, and communicate with each other. While many surgical resources are community-generated, the onus of providing medical information about surgery should be on the surgical team. We sought to understand the potential for an online space for surgeon and community engagement. We assessed gender-affirming surgeon perspectives on online communication and communities by conducting a survey (N = 55) to understand current social media use and gauge surgeons’ opinions related to participating in online spaces. We found that gender-affirming surgeons were not generally in support of a new online platform for patient-surgeon communication, with 67% responding that a new platform was not needed. Participants identified potential negative implications including risks to patients (e.g., misinformation, liability, and platform use in emergency situations) and risks to surgeons (e.g., the additional burden that the platform would place on their already-limited time, changes to surgeon culture, and safety concerns related to online harassment). Potential positive implications include opportunities to improve patient education and enhance patient care. Our results establish empirical understanding of social media use patterns among gender-affirming surgeons and may inform the design of resources to enable trans patients to receive the information and care that they require when considering and undergoing gender-affirming surgery.

Original Article

Daisy Holland , Luka C. J. White , Marija Pantelic , Carrie Llewellyn

Transgender (trans) people experience health inequalities, which includes inequities in accessing and navigating healthcare systems. General practitioners (GP) in England have a limited role in delivering trans-specific healthcare. Few studies have explored what is positively working in GP-led primary care settings and how this can be more widely implemented. This study aims to explore the views and expectations of trans people regarding primary care services. Data were generated using qualitative semi-structured one-on-one interviews conducted with trans experts by experience who were recruited through purposive sampling. Results were analysed and coded using a thematic analysis framework to identify key themes. Positive and negative experiences of accessing and navigating general practice settings were identified by 16 trans people as experts by experience. An overarching theme was for gender-affirming services to be provided through general practice in order to reduce waiting times for specialist care and to move towards an informed consent model of care. Through demonstrating examples of good practice, general practitioners are advised to take a proactive role in providing positive gender-affirming healthcare for trans people. An informed consent model of care should be implemented to improve healthcare access.

Original Article

Lynne Regan

Negotiating the university environment can be difficult for many students, but for transgender students there can be additional hurdles. With university often being the first experience of real independence for young people, it may also be a place where they feel they can be themselves for the first time, as they navigate an environment away from family and friendship ties from the past. Employing a transformative paradigm, I used an online survey to investigate trans student experiences across different higher education institutions (HEIs), and remote one-to-one interviews to explore in-depth perspectives and voices. I examined the challenges these students faced around themes of harassment, bullying and transphobia, representation in the curriculum, and institutional facilities and administration. Participants reported feelings of segregation and otherness resulting from difficulties changing names/genders on HEI systems and insufficient gender-neutral facilities on campus. A lack of trans representation in the curriculum was clear and students reported obstacles accessing mental health support services. I identified institutional cisnormativity as an explanation for many of the negative experiences and apparent exclusion of this student group.

Original Article

Coltan J. Schoenike

Deeply-seeded issues of cisgenderism and discriminatory bias are continuing problems that slow equal rights advances and facilitate further harm for transgender and gender diverse communities - and research literature is no exception. A salient example of this is the historical and ongoing works of Dr. Kenneth Zucker and his colleagues. Previous research by Ansara and Hegarty (2012) has already illustrated this in detail, noting these researchers were often the most cisgenderist while having the highest degrees of influence. This review of literature examines a collection of Zucker’s first, second, and third author works from 2010-2022 using Anasara and Hegarty’s (2012) framework of binarism, misgendering, and pathologizing to assess cisgenderism within the writing. A lot occurred over those twelve years, including Zucker’s work as chair of the Diagnostic and Statistical Manual of Mental Disorders work group for the gender dysphoria diagnosis, the controversial closure of his youth gender clinic in Toronto, and massive increases in visibility and discussion of transgender healthcare. In many ways, it appears that Zucker’s pattern of cisgenderism has continued. This review of literature explores this pattern in detail and offers insights as to why many of these ideologies are harmful to transgender and gender diverse communities.

Original Article

Florence Ashley

Adoption is increasingly being discussed as an alternative to procreation for trans youth given the impact of gender-affirming medical care on fertility. In this article, I caution against idyllic views of adoption and offer a critical perspective on the social, political, and ethical dimensions of adoption. After reviewing adoption’s relationship to sexism, racism, imperialism, and cisheteronormativity, I sketch an alternative view of adoption as a complex and multi-valenced form of care in an unjust world.

Original Article