Transgender bodies can be defined in many ways, feminist Meyorwitz (2002) defines it as “transforming bodily characteristics of sex with hormones and surgery” (Stein, 2012). Throughout the history of transsexuality, there have been various forms which have surrounded around how people have desired to be the opposite sex by dressing as a male or female (Meyerowitz 2002:5) which both men and women have engaged with, however throughout history there has been a stigma drawn towards transgender with medicalisation being one of the main influences.
The ONS report, Trans Data Position Paper (2009/15), suggests that it has become difficult to collect data about transgender bodies as people prefer to be described differently to others and the premise that people have the right to privacy; which included difficulty to have complete accuracy, this included their sex and gender history (OFNS, 2018).
Although there have been substantial changes in the stance of transgender bodies, there has is an ongoing problem of transgender identification. Butler (2004) asked “if i am a certain gender […] will there be a place for my life? And will it be recognizable to others upon whom i depend on for social existence?” which Illich’s (1976) statement “medicine undermines health not only through direct aggression […] but also through the impact of its social organization” supposing that the medicalisation of transgender bodies affects a person socially as well as medically. There are several problematic factors in the trans-bodies agenda due to the medical influence, some transgenders prefer not to undergo medical procedures to be “transgender” however medicalisation has different views because if a person does not go through with medical procedures they are labelled as having a disorder, whereas if they change their sex and have hormones implanted they are classified as fully transitioned. Being labelled as having a disorder can introduce the mental health stigma, where again medicalisation can be introduced as providing medicine to overcome the “disorder”.
According to research, medicalisation may be accepted or rejected by people who identify themselves as trans. Some may argue that the DSM procedure is appropriate due to the fact that they want hormonal and surgical procedures, however, others believe that this supports trans being labelled as “deviant” (Sanger, 2006). This is supported by Butler (2004) and the statement about how some diagnosis may mean life or death to different people, suggesting that there are different ways and viewpoints that trans people prefer – some may engage with the medical route however others may choose not to.
Butler’s statement concludes that there is a stigma towards people who are trans, gay, lesbian etc. and Illich would surmise that this is because of societies influences towards trans bodies; however, Butler also stated that there is few transgender theories which focus solely on the implications medicalisation has upon transgender people and the “feminist theory” is an example of this. There has been a case of radical feminists who have disagreed with transgender people being allowed to attend “women only” campaigns, Sheila Jeffreys (2003) suggests that trans women are seen as a threat to women’s liberation which could be linked to why trans women may take the full medical scale and undergo full procedures to become a woman from a man. However, Jacqueline Rose (1986) suggests that instead of comparing what a woman should have or what women are or should have, women should work together regardless of their gender identity.
From this, medicalisation can be intervened with transgenders as the is a stigma around it due to people being categorized as having a mental disorder. In the Diagnostic and Statistical Manual of Mental Disorders (DSM), gender identity disorder is classed as a mental health issue; and people who wish to undergo medical transgender need to have a psychological assessment (DSM-5, 2018) – this moves trans people “out of the norm” in regard to their mental health, however, “normality” can be achieved when they are socially accepted (Sanger, 2006). This suggests that it depends on societies views and opinions before someone can be accepted, which could lead to gender discrimination if some people do not agree.
This argument can be supported by the social constructionism theory, in which Ingleby (1980) suggest that mental health is socially formed by psychiatrists who have the power to control society. From Ingleby’s statement, it could suggest that psychiatrists begin to form social norms and who is deviant within society and trans-bodies can be involved with this because they supposedly have a “gender identity disorder” what could be the stigma that creates the “deviant” body of a transgender person.
There are some theories which go again the social constructionism theory, Nettleton (2013) proclaims that if knowledge is medically and socially constructed then social constructionists can not proclaim their views are valid, Nettleton also states that if this is the case it is “relativism”. In another statement, Nettleton (2013) suggests that medical achievements in the past provides evidence that scientific knowledge and practice is more secure than others, suggesting that if a person is transgender it would be better practice using scientific knowledge i.e. biology of a man and woman’s body to determine the transition than it would be to use social views and medical views.
Although there is sufficient information that there is a lean towards societies views to determine transgender bodies, Bury (1986) believed that medicalisation was in fact conspiracy and that not every doctor acts in dominant ideology (Gabe and Calnan, 1989) which suggests again that medicalisation depends on the medical professional who is dominant for the person wishing to undergo transgender surgery or classification; however this could become dependent on opinions which is not ethically considered.
To conclude, there is sufficient evidence that in regard to transgender bodies their “labelling” is socially constructed and there is a turn towards how this may depend on the medical professional that they work with to undergo their transgender classification. It is also suggested that a transgender person must be medicalised to be able to classify themselves as transgender otherwise they are labelled as to having a mental health issue. However, some arguments have raised that scientific knowledge is the way to undergo procedures as social construction may be built up form opinions which cannot be ethical declarations of how a person can be viewed as normal or deviant.
By Sasha Smith
Medicalisation, Normality and the Body 