Eliza Mondegreen goes to WPATH

There’s a lot to say about it and I’m still processing. But one of the things that fascinated me about the World Professional Association for Transgender Health conference was how persuasive is the feeling that you're making progress. The language is always changing and so you're Always Learning. The frontiers of identity are always expanding. Everything can always be made more 'inclusive.' Techniques can always be refined.

It's easy to lose sight of what you're progressing toward: sterilizing more kids, earlier, on thinner and thinner pretexts, regardless of comorbidities, despite mounting evidence of both social contagion as a driver and medical harm as the outcome.

Just a few short years ago, surgeons didn't know how to deal with underdeveloped penile tissue in "affirmed AMAB individuals with early puberty blockade" but now we know how to 'quilt' a fake vagina out of colon and scrotal tissue and other donor sites.

A few years ago, the scales we used to justify experimental medical interventions on teens were so binary but now we have special genderqueer scales that let teens rank how many body parts (out of a possible 33) they want to surgically alter!

Some clinicians once felt very uncomfortable performing 'gender nullification' surgeries (cutting everything off) but then they Did The Work and now they're treating more patients than ever!

Isn't progress for progress's sake a beautiful thing?

Because trans is always in motion, even the most dedicated adherents must rush or risk falling perilously behind. They never get a chance to catch their breath and take a long look at what they're supporting, much less question it.

Something I've been curious about since I was a child is how ordinary people get swept up in terrible and terrifying movements. The answer is usually some variation of: They think they're the bold vanguard of a bright new future and that History will dispense with their critics.

It's convenient to think of yourself as being on the right side of history. Your critics become dinosaurs in their own time, incapable of understanding. You may be incapable of understanding, too, but at least you have faith. At least you have given yourself over to the cause.

The further you go—the more patients you cut up, the more critics you silence—the harder it is to see your destination clearly. But it must be beautiful and just because you've sacrificed for it and identified yourself with it and you are a Good Person.

The entire conference spoke to this Good Person. You are a good person because you are overcoming your biases. You are a good person because you oppose the bad people (even if you don't understand them and we won't talk about them because that would be like letting them win).

You are a good person because you get it. You aren't one of those reactionaries who balks at hysterectomies for troubled teen girls. You affirm that this is life-saving, gender-affirming care. Any good doctor would provide it. You don't feel the horror anymore.

You know that you're a good person because you don't feel horror but exaltation. Only bad people feel horrified at such things because they haven’t done the work.

The endpoint of this education in 'allyship' is a person who cannot question what she supports because she cannot see it, because she lacks the language to formulate the question, because she lacks the confidence of her own perceptions, because she has 'problematized' away any ground she might stand on or any principle she might insist on. She looks on real horrors with starry eyes because she must.

Of course the bad feelings don't really go away. The horror doesn't go away. But you lose touch with its true sources. You project it on the only people against whom you're allowed—encouraged—to vent bad feelings: the people trying to warn you you’re causing harm.

The more horror you must sublimate, the more horrible your detractors must become, even if the worst thing they say is simply: look. Look at what you’re doing.