I Did Not Consent To My Body

A personal essay about trauma, transition, and transgender autonomy.

Content warning for discussion of transphobia, trauma, C-PTSD, violence against a child, threats of sexual violence, minority stress, and suicide

I often feel ignorant about trans news, but it’s a special kind of ignorance— stemming not from a lack of awareness, but an excess of it. There’s so much I can’t bear to look at it. I haven’t been able to bring myself to look very deeply into the recent Cass review, a document attempting to furnish a medical basis for opposing transition care. Many trans and pro-trans writers have nevertheless made short work of identifying the review’s narrative. It’s a familiar one: cisgender people are worried about whether transgender medicine is really effective, whether it really makes us happy. They’re worried that these supposed cures might actually be recipes for regret.

The dominant tone of that narrative is concern. The role of cis people in that narrative is those who feel the concern. Parents who want to protect their kids, doctors who want to protect their patients, from an existential onslaught. The role of transness in the story is much murkier. Transness represents not a kind of person as much as a spiritual force, one luring children not only away from their parents, from their communities, but from their very bodies. This force undermines the body’s natural beauty and innocence, threatening the building blocks of human society: childhood, family, and sex itself.

My familiarity with this narrative is what makes it impossible to face. Despite its power to impact my life, I recognize that it’s a story in which I fundamentally do not exist. The story contains no trans people, just victims and carriers of transness-as-force. A force that appears to be no less than the stuff of suffering.

My rejection of this story and its conclusions doesn’t mean I don’t understand it. Particularly the feelings behind it — in fact, those feelings are startlingly easy to empathize with. Their range is too wide to encompass here, but some of them are ones I myself felt when I began coming to terms with the fact that I’m trans. It’s easy to imagine the perspective of a person who looks at trans people and predominantly sees suffering. Surgical scars, removed reproductive organs, irreversibly changed bodies.

But it’s bigger than that. Trans suffering is perhaps more widely seen now than ever before, and the picture is grim. Mass poverty and homelessness, sexual and physical abuse at rates no less than extravagant, substance dependency and incarceration and death. And suicide. Suicide seeping through everything. Suicide is so iconically associated with trans people that all you need do is say “41%” and many people will know exactly what you’re talking about. Some have argued that these signs of misery are proof that transness represents a terrible state of illness. That this misery rises spontaneously from within our bodies, a cold and polluting spirit spreading its dire halo. Many cis people feel they can do no less than fight to defeat it.

Certainly, also, many cis people know better than that. But it’s a hard image to contest. It’s easy to understand why one may conclude that trans people are choosing suffering, and to wonder what possible justification exists for that choice. Even enlightened cis people may think that surely, you don’t go down this path without a reason, without considering risks. I recall my first gender therapist, a warm and friendly woman I met years ago in a sunlit counseling room. She affirmed the authenticity of my transness before telling me it was lucky I didn’t look any manlier than I did, or else transitioning would not be worth it.

It’s likewise easy to empathize with frightened cisgender parents who only see their children being swept away by this force into dark lifetimes of privation, vulnerability, loneliness and loss. I remember my own mother, when I told her about my desires for hormone replacement therapy, meekly expressing a fear about this putting me at heightened risk of breast cancer—a way to gesture at the anxiety “what if something goes wrong?”

Feelings are easy. Seeing them, relating to them, mirroring them. Everyone, cis and trans, is animated by feelings. Our actions arise from complex tides of feelings, feelings we long to have relieved. I can look inside cis peoples’ feelings all day long and never struggle to understand them. I would relieve them all if I could.

Feelings are much easier than conclusions. Conclusions are hard, especially when they’re about things your feelings won’t let you see.

To the extent that we trans people choose suffering, we choose it because it’s the logical conclusion. We know we’re going to suffer. We already have suffered — that’s why we’re faced with the choice to begin with.

I don’t know how to talk to cis people about this. I don’t know how to help them conclude that our choices make perfect sense, if you have all the facts. If you understand the real source of our suffering.

I don’t know how to tell cis people that the real problem, the one they think they’re saving us from, is them.

The Cure For Starvation

Trans reporter Evan Urquhart recently published an essay that garnered some controversy on social media. His essay, In Defense of the Medical Model for Trans Healthcare, replies to a preceding piece by award-winning trans writer Andrea Long Chu. Her piece, Freedom of Sex, was not one I’d read previously, but it shimmers with qualities I consider iconic to Chu — at once incisive and blistering, like fire cutting rope. Chu says in her 2018 New York Times piece “my new vagina won’t make me happy,” a sentiment resonant with her present-day argument, which is that the autonomy of gender transition — of sex change — should not rely on the power of that process to alleviate pain. HRT and vaginoplasty may not solve her suffering as a trans woman, Chu explains, but she deserves to choose them nonetheless.

Urquhart criticizes this position as, while not outright wrong, misconstruing the crisis of trans healthcare and medical autonomy, ceding unnecessary ground to anti-trans narratives along the way. He summarizes this neatly with the tagline “Andrea Long Chu thinks libertarianism will save the trans community. That’s bonkers.”

He argues that while Chu’s framing emphasizes the good of medical autonomy over actual medical outcomes, this framing implies a lack of confidence about the outcomes themselves. There’s a reason we tell cis people that we need this — we do. Remember all those feelings of concern. Cisgender people who see our own life choices, including our chosen medicines, as the source of our suffering are concerned about how carefully we make them. They may cede that we have the right to those choices if nothing else will do. The eagerness of trans people to make those choices, and to help other trans people make them, may look from the cisgender perspective a lot like lack of concern. Why are trans activists not being more careful with our children? Now one of these activists is even admitting that transition may very well leave trans people unhappy with the results after all?

Urquhart insists that whatever might be said about transition medicine, it is nevertheless still medicine. It still heals. My own guts demand I affirm this point. As someone who began medical transition only just over a year ago, denying the healing power of that medicine would viscerally appall me.

It’s . . . hard to talk about HRT. To do so, I must also talk about starvation. I knew I wanted HRT twenty years ago, but wanted seems too mild a word for what I felt. I wanted it in the same way thirst is the want for water, knife-like hunger the want for food. I ache for that younger version of me, who despaired at how many years she would have to wait for for this vital medicine. She had no idea how long she could starve and remain alive.

Craving and privation combined in my mind to elevate medical transition to the status of a miracle. The reasons for my difficulty accessing transition care are too many to list here, but they too are a picture of trans suffering. Most trans youth around me today don’t have to wait so long, a fact that fills me with joy. Anti-trans critics would undo this fact. They would preserve a world of forced starvation.

Receiving that medicine did not disappoint. My relatively short time on HRT has been nothing less than catastrophically healing. Some restorations are so beautiful they are almost disasters. The medicine awakened magic that slept long in my bones, magic that breathes sensation back into parts of me I’d feared dead forever. Magic that regenerates the future even now, as I write this, resurrecting possibilities I’d spent years mourning.

My happiness is apocalyptic — as if surely the world must be ending, if I am finally allowed to be this happy. Understand, then, why this happiness must also be grief. Water tastes the most like heaven when you are dying of thirst. No medicine could be so sweet had I not been so nightmarishly hungry.

“But does the medicine make you happy?” can therefore only be an odd question to me. We may as well ask: did birth make me happy? Does a planet capable of sustaining life make me happy?

This was not the most controversial question, however. Urquhart says, “If trans people really could take a pill or have a few therapy sessions and become cis, like it or hate it, most of us would probably choose to do so.” It implies the same question cis people are asking: why would someone ever choose to be trans?

This is not a new position for Urquhart. His 2018 Slate article expresses the same thesis right in the title: Being Transgender Is a Condition, Not a Choice. His core argument is that “transition is the only known effective treatment for gender dysphoria,” that the legitimacy of gender transition depends on the singularity of its healing power.

He says that he tried with all his might to be cis, and that he’d still have chosen that if he could. This hurts my stomach to read; my responsive wave of empathy is almost dizzying. I don’t wish to put words in Urquhart’s mouth. But I can’t help but interpret this sentiment as also an expression of suffering. When the medicine trans people need isn’t available, we can spend much of our lives looking for one that is. Sometimes the only medicine left is annihilation.

Remember the way suicide plagues our kind. Some trans people brace for suicidality years in advance, not wanting it to come but knowing that it will. It doesn’t come from nowhere. In my 2021 novel The Calyx Charm, one trans character says “Suicide is murder by a hand that happens to be away at the time.” Suicide at such a scale must be engineered. If you forcibly starve someone, of course they eventually want to die. There’s something utterly twisted about concluding that the food the starving person craves must be the thing killing them.

But suicide, like starvation, is only one form of annihilation. Annihilation is trans peoples’ bread and butter, the thing we get instead of nourishment. Because of that, many of us show signs of seeking out annihilation, approving of it. Self-harm, self-hate. Numbness. Recklessness. Drug overdoses. Staying in abusive relationships. But one of the subtlest and most common forms of this is the feeling that we’d be better off not existing. If only I could have just been someone else. If only the person I am had never been born.

Please understand my tenderness for such feelings. Annihilation is the first cure for starvation many of us find. But my love is no less for the desire to finally reject that annihilation. I usually see this desire in trans people as a renewed fervor to accept the person that they are. I see it in Chu’s frankness about her unhappiness. I see in the trans people who responded to Urquhart that they would never choose to be cis.

Conclusions are often harder than feelings. I nevertheless conclude that Urquhart is disregarding not only a critical piece of Chu’s argument, but the context in which he makes his own.

The trans medicine debate seems like it’s about what will heal transgender people, but it isn’t. We already know. We know the cure for starvation.

The debate is about whether cis people would rather we starve anyway.

Your Body As A Tragedy

HRT came along with access to other care I’ve also needed for many years. Part of that care has been psychotherapy that’s helped me understand something about myself: I have childhood C-PTSD.

C-PTSD–or complex post-traumatic stress disorder — can be tricky to treat. The first instinct is often to investigate the traumatizing events, which is sometimes necessary to even understand your symptoms. However, many trauma specialists observe that talking about the traumatizing events, mentally reliving them, can be retraumatizing — it can make the symptoms worse.

This relates to the difference between the trauma itself and the events that caused it. Trauma is the body’s reaction to those events. Notice that I say the body and not the mind. It’s more than just memories, beliefs, or even feelings about a thing that happened to you. On the contrary, many traumatized people don’t fully remember the events that traumatized them. Trauma is a permanent change to your nervous system, one you can’t get rid of. And if that change started early enough, the trauma is a foundational part of your personality. You are not you without it.

I am not me without my trauma. I don’t know where I end and it begins. It’s in my lifelong insomnia, my chronic pain, my paralyzing fear of abandonment. It’s in the way I cringe at being touched. It’s in my sense of the world as fundamentally terrifying.

I recall hearing once that the surest sign of healing from C-PTSD is that the survivor loses interest in the story of their trauma. That’s a gorgeous thought, but I’ve never been sure of how to apply it. Which story is about my trauma, and which is about me? My trauma story stares me down in the mirror each morning. She’s in the shape of my face, the sound of my voice, the texture of my skin.

My traumatic events are too many to list, which may be part of my problem. I’ve written a little about them in past essays. Their general theme has been disgust, shame, and punishment, all revolving around my trans girlhood, which was already so obvious by age five that you could see it from space. I don’t remember all of them. I do remember my entire first-grade school year disappearing into a panicky blur. I remember a once-beloved teacher becoming a figure of fear. I remember boys telling me they were going to rape and kill me. I remember being absolutely numb. Like a dead thing, cold on the ground.

But one traumatic event seems to define me more than the rest. If I could remove only one traumatizing event from my history, it would be this one. I don’t know how I’m supposed to lose interest in its fiendishly captivating story. It looms in the background of my emotions, so big I forget it’s there, the breathless night sky upon which my darkest fears unfold.

That event was called puberty.

I didn’t quite get how true that was until last year, when I uttered words to my therapist that were surprising to hear from my own mouth: puberty ruined me. Part of the surprise was how emotionally true those words ring, how good it is to no longer pretend that this isn’t how I feel. That puberty ruined me.

I dreaded my puberty long before it came, knowing in my guts what it would mean. Those feelings may sound shocking, evidence of mental illness, but they’re only mysterious if we discard the clear message I was sending to anyone who would listen: I did not want to be a boy.

The experience was of my body being turned against me with no way to stop it. Puberty took control of my body, shaped it into a form I had begged not to have. It was like a new form of trauma, a permanent change to who I am, except this time it was written into gruesome visibility. In my appearance, my face, my voice, my very size and shape. I experienced puberty as an invasive force, penetrating and possessing me. Puberty taught me that my own body, which in theory should belong to me, could be made into yet another punishment. Yet another traumatic event. Even the most private part of me, which should have been my shelter from the shame, became a thing of fear.

But it was worse than that. The changes in my body include permanent outward markers that I’m a trans woman. That I am the thing everyone already knew I was. The gendered character of my early traumatic events are consistent with patterns of young trans girls being highly vulnerable to polyvictimization. Not everyone knew what they were seeing, or what it was called, but they were still seeing it.

Puberty ensured that everyone would always see it, that the stigma of that victimization would be visibly stamped into my bones. The same violence, disgust, shame that had already traumatized me would return, made inevitable by the markers I was forced to wear.

It’s not that I think being a boy is bad. It’s that I didn’t consent to being one. I didn’t consent to a puberty that would mark me as one to the rest of the world. But these feelings didn’t even get to matter. My consent didn’t get to matter.

I argue that we should consider my forced unwilling puberty as a kind of sex change, a compulsory sex change. It and my trauma are bound together in the same ruin. The ruin that taught me that my body did not belong to me. It seemed to belong to everyone but me. What I had wanted for it was the last thing that mattered. It made a tragedy of my body.

It’s easy, then, for me to empathize with a cis person who regards sex change with primal fear. If that sex change is unwilling, having to go through it is a form of annihilation. Annihilation that goes beyond destruction and becomes a physical thing unto itself, one you’re forced to live in for the rest of your life. I understand the fear because it’s a form of annihilation that actually happened to me.

So if everyone is afraid of this . . . why did it happen?

The End of Tears

One could argue that at least in a case like mine, medical transition itself is retraumatizing. It’s been showing me the puberty I wished I could have had, displaced by thirty numbing years. My body didn’t have to be ruined in the same way that I didn’t have to be ritually abused as a child. The return of sensation is also the return of pain. The surfacing of decades of unshed tears, the decades of annihilation those tears mourned.

How completely backward it is to blame the medicine. To treat the tears as the problem, and not the annihilation.

Understanding suffering, like medicine and the body, requires sensitivity to consent. But the consent of trans people is almost never allowed into the trans debate. It was a relief to see Chu explaining her argument in exactly these terms: “But if children are too young to consent to puberty blockers, then they are definitely too young to consent to puberty, which is a drastic biological upheaval in its own right.”

For a topic so centered on the horror of unwilling sex change, there’s shockingly little admission that unwilling sex change is precisely what cisgender society expects trans people to endure. The great fear of cisgender people — the terror we seem to symbolize to them — is our everyday. Our consent, or lack thereof, doesn’t get to matter. We don’t matter.

I’m struck with the irony of saying “feelings are easy” as I write this essay. A sea of other people’s feelings, including about my body, that I feel almost more clearly than my own. Because there is a hole where my feelings were. Even they were annihilated. In this debate, in this story, I do not exist. I am a dead thing on the ground.

The genius of the consent framing is that it implies the threat of violation. A puberty — a gendering — that happens against our consent is violating. Violation causes trauma. Trauma informs trans suffering. And when that trauma is written on your face, it makes you into a bullseye for even more violation.

Anti-trans violence and unwilling puberty are joined pieces of a machine. Trans medicine may not be able to completely undo the harm, but its healing power isn’t just psychological. It returns some of our power of consent, and reduces the markings that make us vulnerable to more trauma. Why should we see the suspicion for that medicine as anything other than another part of that machine?

Another memory bubbles up. A preteen trans girl being held down by a pair of boys so that two other boys can beat on her. Bodies press her into the dirt. Their fists crack through her numbness. They pull out her tears. She worked so hard to hide those tears. No reaction, even lack of a reaction, was ever going to protect her for long.

Afterward, the question was never why do they beat her? Not how do we keep them from beating her? It was always why won’t she stop crying?

First we crack you open. We make you hide the places where we broke you. Then if you desire care, we make you prove you’re broken. When you do, we say that this means you were broken from the start. We justify our mastery over you, the same mastery that crushed you.

I can’t follow the trans debate because I know what I’m going to hear. The real question under it all: why won’t they stop crying?

Two voices arise in my mind. One is Evan Urquhart, saying, “If you stop beating her, she’ll stop crying! Don’t you see that?”

The second is Andrea Long Chu. “She may never stop crying,” she says. “You still had no right to beat her.”

How You Stay Alive

I’ve been learning this past year what might be the most important thing about my trauma. Not the symptoms, not the causes, not even the treatment. It’s this:

My trauma is the reason I’m alive.

Trauma is just a survival program. When your body knows it isn’t safe, it declares emergency mode. If you get a chance to heal, you can come out of that emergency mode. But if the violation continues, your body knows what to do. It’s a paradoxical magic unto itself. My numbness, my fearfulness, my way of feeling other peoples’ feelings more easily than my own. These are all ways my trauma has helped me endure my life.

Trauma is the refusal of annihilation. Understanding this changed my entire view of my life. I felt that my trauma was the worst part of me, a ruin I would never escape. I understand now what my trauma really is: my body’s way of saying that it loves me. Greater still, that it loved me all along. It’s my body’s faith in me, that I would get us to safety. That I would someday find the cure for our starvation. Through the darkest times of my life, my trauma was the only clear proof that my body belongs to me.

When Andrea Long Chu says that her vagina will not make her happy, I hear her saying that her unhappiness is part of who she is. Trans suffering is part of who we are. It’s the clearest proof that our bodies belong to us. That our needs and feelings matter. That we are not dead things on the ground.

Evan’s perspective, too, is an understandable part of who he is. I understand wishing yourself away. It flows from the desire to be free from this suffering. Sometimes the only way you know how to express that feeling is “I wish I could have just been cis.” That feeling matters. But it doesn’t mean the conclusion is correct.

Trans medicine heals. It heals beautifully, painfully, with fire and magic and wonder. It restores that which appeared dead. It teaches you that your body can be yours.

But trans medicine alone is not the cure for trans suffering, because that suffering is not medical in origin. The origin is cisgender society’s profound hostility to trans existence, its total denial of our personhood.

The trans debate reifies that denial of personhood. It retraumatizes us. It’s cruel to talk about our happiness—to hold our happiness hostage—while this goes on. It reinforces the very thing that threatens to annihilate us: the overwhelming dominance of cis people over our lives and bodies.

It’s so hard to fight that, we’re usually left defending what we have—our trauma, our medicine, our magic. Our ways of staying alive. Of course I want to defend those things. Of course I think they work. Of course I also think that they shouldn’t have to be proven to work for us to have the right to keep them.

I’m not sure what my conclusions are for fellow trans people like Urquhart and Chu. My feelings are much clearer. My grief at their pain. My gratitude that they’re, like me, still alive to have this debate. My rage that this is the debate we’re made to have.

One conclusion I can be sure of. I did not consent to my body. What that means is that I did not consent to the way my body was treated. I did not consent to a world that would violate it.

I can’t conclude, then, that transness should be understood as a force, as a condition, or even as a choice. Transness is part of who some of us are. It’s a beautiful, precious thing that should be cherished and protected. I conclude that, whatever the justification, cis people have no right to annihilate it.

The conclusions that are hardest for me to find, though, are the ones I’d offer to myself. To the girl in the mirror, in the story of my face. My trauma and my magic, making up my body together. I can offer her this: I love her. Violation taught me to hate her, to see her as the ruin of my life. Perhaps the greatest sign of my healing is that I no longer want to. In place of that story of ruin shines the sincerity of my love for her, my passion to be on her side at all costs. She belongs to me. I am not me without her. She kept me alive.

And I will never wish her away.