Last few days have had so much energy eaten by discourse that I need to put my thoughts down, I have work to do and a life to live. This may not be eloquent or useful, but will summarize my responses to two recent papers; one of which I read in detail; both of which end up screenshotted all across trans twitter and so keep reactivating me. For some reason in combination I end up in apathetic dysphoria freeze/spirals like I have only very rarely done post-transition, and it has been relevant to understand why.

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First I recently wrote of: literature review (Gliske, 2019) of brain scan studies identifying dysphoria correlates, only new thing being author postulates these are causes not symptoms and that direct modulation may (some day) alter them, reducing dysphoria. Such conversion therapy need not hinge on the flawed theory of the author, but is a more general philosophical question now gradually actualized – we are developing both invasive and non-invasive brain impact methods (transcranial magnetism, electrodes…) and it does not seem entirely unreasonable it will become possible with a willing subject to combine with methods like in EMDR – activate certain pathways and selectively dampen/erase them over and over, as a way to alter habitual reactions or the response to thoughts and memories.

Any such method will of course be highly variable in efficacy, take many years to get past initial horrorshow stage, and with side effects. The closest I can see possible in the case of dysphoria is something like an augmented PTSD or phobia treatment, where eventually one feels just a dull, neutral ache which activates no panic. It is the modern version of “learn to endure it”. There exists trans people who try now doing the latter; many of whom are in impossible situations where they feel they can never become cis passing, never accepted, etc; those would probably – will probably – become the test subjects. Some will consider themselves successfully “cured”, others will not. For those, I suppose I do not begrudge them whatever they do, I am simply sad for them and angry for a world where puberty made so much so difficult for some of us.

Others – me, and perhaps most of us – would neither accept the perfect “become cis of your AGAB” magic pill or the above laser-guided exposure therapy “learn to endure it” treatments. We want to be what and who we are, we just want smoother and more effective transition. It is the potential consequences for us that frighten me. Essentially, when there has emerged – and I can’t really afford to just blanket say it cannot – some sort of trial therapy like the above, with a handful of detransitioners touted as “successes” because they no longer have debilitating dysphoria manifestations, then there will begin to be voices saying that we already then have that sort of conversion therapy as an alternative. Those voices will be heard by conservatives and by health insurance systems. If it is cheaper to make us less depressed and suicidal by conversion therapy, than to let us transition socially and medically, they may not deny us the latter legally, but would have a much easier time denying us support (social and insurance-wise) in pursuing it. What we suffered from being read and understood wrong, and in the wrong kind of bodies, would be considered our own faults, since we did not choose to have our painful, impossible wish lobotomized away.

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Here then the second paper (Byrne, 2019). I had not planned to read it, but sitting down now to collect my thoughts I did. I technically have more formal training in philosophy than in neuroscience but am more outside this field, so perhaps I miss out on sensible reading aspects someone better anchored would – somehow I doubt that. Byrne is head of philosophy and linguistics at MIT, and in this his first paper on sex and gender he took help by noted anti-trans voices including Blanchard, Stock and also anti-trans trans people like Andrea Long Chu and Debbie Hayton. From the start I think there is a fundamental disconnect here between Byrne’s views and mine, as he believes words have some sort of meaning which exists beyond the pattern of their use, interpreted most generally. This is where perhaps actual trained philosophers could tell me that this in fact is a widely accepted view, though it still is not mine – I see words and concepts as patterns of human perception, action, emotion, position and thinking, with anything than the full set of all human thought at any moment being a symbolic (statistical) simplification, and with statistical and imperfect correspondence to anything outside subjectivity. Never mind that though.

Byrne wants to defend the concept that “woman” should mean “adult human female”, and that it explicitly refers to something biological, not something social. Broadly speaking he lists various ways in which people broadly use the concept and speak and think about womanhood to mean, usually, just that, and he paints this idea as something persecuted and controversial among philosophers but not among sensible ordinary people. The text is rambling, tone widely shifting, type and extent of reasoning fluctuating and he makes some casually thrown in problematic assertions, chief among them, from some few anecdotes, that third gender people across the world really mostly have been femme gay men (my intuition being: many many people throughout history, if given the option to transition legally and medically, would have; many ambiguous states were second best options, just like mine was, but of course not all). He also randomly makes up an intersex condition instead of using the perfectly applicable CAIS XY one, then goes on to say that intersex women neither are women or female, but that they should be called that, and treated as such, out of kindness – second class womanhood, and very jarring against the rest of the text which highly praises some sort of honesty to imagined concepts; if one’s concepts means one should not speak and act according to them, then are they really sensible concepts to hold? He also willfully ignores how “cis woman” or “birth-assigned woman” is perfectly serviceable for addressing people where that holds.

All in all the argumentation is thin, repetitive and there is little to summarize beyond, “based on various assumptions, this is how we use this term, or ought to use it”. Instead I best summarize my impressions by my counter position. This is that, as noted, words and concepts are their usage, therefore sometimes very fuzzy. Words like woman (girl, etc.) have cultural and contextual meaning that go far beyond the biological; this ambiguity does not cause us any problems in practice, we understand to use them in this way and are able to give them specifying qualifiers when we have to. Many important usages of the term has nothing to do with biology and everything with social positions; in many cases such usage overlays partly with a usage that references biology. Again, this is not in practice confusing. We are able to communicate this just fine. So saying the concept is solely biological is not true, because only some forms of it is.

That said, I have no issue at all with those forms of the womanhood concept referencing “adult female humans” a lot of the time they are used. This is because I do not use the term “female” in the same way that Byrne does. First, that term too has the same multiplicity of effective meanings as do “woman”; we use it also to reference social positions and symbols a lot of the time, not merely biological. Here I know there is disconnect – my use of the word is spreading but not as accepted yet. More so still within the areas that this discourse actually is about, namely the status of trans and intersex persons. My concept and linguistic use of “female” in the biological sense applies to any person that identifies as such. I have written of it elsewhere but will briefly reiterate this idea.

Essentially, as a biologist, I reject the unqualified use of sex/male/female as biological terms. There are any number of sexed properties – within anatomy, endocrinology, reproductive lineage tracking, genetics, gene expression, and for animals – human ones also, perhaps – in behaviour. These are not discrete; we can define an infinite number of ways of tracking aspects of the same concept, so one could speak of as many separate but correlated sex characteristic continua as one wants. Usually but not always they are bimodal but not separable. I believe that some philosophers apply a “cluster definition” to define “male” and “female sex” out of this, but in the end, as for any other concept in biology, we need to make definitions when we establish terms which are not compelled from the data, but are choices we make – this is where also STEM concepts become social constructs. We cannot take an average of an infinite number of dimensions, so there is not a single obvious way to choose where in this space to put a boundary between “male” and “female sex”.

Much easier in each subcategory. My body has largely female endocrinology, for example, no real reproductive capacity any longer, largely male karyotype, intermediate anatomy of a lot of tissues. And in that aspect of neurology and behaviour which is also part of my biology, I declare myself “female”. When trying to decide then on that short hand which is (unqualified) sex, or biological sex, I have the following concept, and it is one I try to propagate to others, and which I want eventually also to propagate in research literature: default to anatomy, gonads and karyotype in that order, but if the person themselves opts out of either maleness or femaleness, or opts into either femaleness or maleness, through honest self-declaration, then consider that the determining factor.

This does mean that for some person like mitochondrial Eve, whom Byrne references and say we know without need for qualification she is female and a woman, I will believe her female since I know she had female gonads; I do not know but have no reason to believe she would have opted out; since I know only she is likely female, I will consider her likely a woman, and use she/her pronouns to describe her until I know better. Byrne references some newborn child with XX karyotype and a vagina; here again I will consider them likely female but I am not sure it is a good idea to speak of them as she, the girl, until they tell me so – here, in fact, would be somewhere we could shift the Overton window leftwards, a currently unacceptable proposal which would still be well motivated – consider no child a boy or a girl until they decide they are, do not speak of them as such, let their initial unchosen names be neutral. This is a position I will not fight for right now but that I favor in principle as a way to not simply let the bigots be the ones expanding the space of what is no longer too outlandish, it is sensible but not yet sellable.

For most people, they will not consciously self-identify as male or female, men or women, but they will be fine with the labels following from above scheme of disambiguation – anatomy, gonads, karyotype – and I will reference them as such unless I hear otherwise, or I have reason to believe perhaps they might in their heart of hearts be inclined to opt in or opt out of the default definition. This is seldom complicated. In everyday situations I don’t ask the receptionist their pronouns before speaking with them; I use names and other social cues to guess until I learn otherwise, but when I learn otherwise, I make damn sure to remember it.

For trans people (I won’t speak for intersex people here and now), we clearly made our choice: either to opt out of our AGAB, opt into our non-AGAB, or both. This already defines our (unqualified and biological) sex, even before we undergo any interventions (and not all of us do). We also occupy social spaces of man/womanhood, girl/boyhood. But beyond this, medical transition alters some of our sexed properties, as I outlined by example for myself above. When I finally have surgery, I will no longer be gonadally male, and yet another few percent of my tissues and structures will be anatomically female. With more years of hormone therapy, more of my gene expression patterns will change, and I will become slightly more physiologically female. We don’t know exactly what does and does not change. Some of my future research aims to test this. Not least in part because I can then determine better what technologies for transition we currently lack.

So in summary, I and my trans sisters are adult human females unless you specify, for example, karyotypic adult human females. I suppose Byrne can call me a karyotypic man if he wishes, and I would acknowledge this, but in the unqualified sense I am simply a woman. The whole kerfluffle of defending “adult human female” is irrelevant for these issues since we should problematize the concept of “female” itself including from a biological standpoint. Which is not the same as denying biology or erasing the needs of cis females. That research I mentioned? The other reason I want to do this is because I want to understand how hormonal and other factors make bodies sick and healthy in different ways in men and women (using here, as usually, the terms as statistic entities, and statements about them being statistical rather than essential in nature), so that the issues cis women have faced with inadequate medication and health advice, with increased mortality as a result, will be addressed. This is the opposite of either ignoring or failing to act on inequities resulting from biology.

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(The above should also make clear something else I have alluded to. I do not see sex and gender as fully separate things. I see both as socially constructed. I see this social construction as being informed by biology, including the biology of brain and behaviour. I do not consider a sex/gender distinction particularly politically useful, and I see conceding “sex” as something immutable and binary and obvious as a dangerous mistake when made by trans activists.)

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So then finally, back to where I was eventually heading, why does the combined discourse of Gliske and Byrne frighten me so? Not only on the practical level (access to transition healthcare), but on an existential level? It is because for me, core to my identity as a (trans) woman is that I need for others to see me as one. When they divide the world into men and women, I need for them to group me with the women (if no division is made, all fine!). I need for this to be heartfelt and honest, for them to genuinely apply any sex- and gender-differential emotion or action or phrasing to me exactly as they would to any cis woman. I will never perfectly have this, of course. And in the end, it is my own view of myself that matters most, but that view is informed by those around me. If society as a whole decides on a conceptualization of femaleness and of womanhood which I am excluded from, then I cannot feel at home.

I feel we have made very significant headway (but also some of it was always there – defining these terms from karyotype is a 20th century thing, definitions before that were likely anatomical but may have had strong social components too, especially in third gender cases) in propagating definitions that include trans people. “Trans women are women, trans men are men, non-binary people are both or neither as they say they are” is widespread enough to positively surprise me. Responses to Gliske (not so much to Byrne) from within his own scientific community echoes this already. We have made strides in visibility and recognition.

Trans-exclusive thinkers (feminist and otherwise) argue that changing definitions in this way comes at a cost. They reference (minuscule, bogeyman, but there you go) risks of abusers gaming the system to harm cis women, loss of sex-specific statistical knowledge (though at worst that is a 2-3% change in any measurement because we are very few), and the discomfort of cis women who have been traumatized by people who look like men and no longer feel safe with them around. Byrne, I am sure, along with others like him would complain there is a lack of simple elegance in my definition above, compared to something as simple as “both XX karyotype and a vagina”, and would argue this lack of elegance also is a cost, in a thought economy sense. Hilary Clinton feels it is awkward to have to expand her view of what womanhood can mean, and other old-school feminists feel their suffering under patriarchy is somehow not acknowledged as strongly if there are women who have not suffered all of it. Not a huge cost, any of this, but a small cost at least.

It is easy to show that what trans people experience under dysphoria – evidenced in our suicide attempt rate to date – is a much vaster cost than any of those minor encumbrances. It also outweighs easily – for many of us – the costs that come from the imperfections of current transition – being a target, as a non-passing trans person in a cisnormative patriarchal world, medical side effects, imperfect surgical options, generally loss of fertility along most paths. It is still easy to show that the scenario where we do transition, and where other people alter their definitions of men and women, male and female, so as to correctly include us, thereby removing main triggers of our dysphoria, is the one of most total utility and happiness. Cis people can suck up the inelegance of definition, the awkwardness of language, the slight fuzziness of statistics and the novelty of tall women washing their hands in a public restroom, because at least it means fewer trans people live in total despair.

But if something like what Gliske surely aims for becomes practice, and becomes widely believed to be an option for us to reduce symptoms of dysphoria? Would then more people side with Byrne, considering the encumbrances I mentioned more important than the remaining non-dysphoric reasons we have to transition? Fundamentally, is my wish to be recognized as a woman, in the absence of a clinical distress phenotype, still important enough to outweigh those encumbrances?

This is what I have been so distressed about. I fear it might not. I fear that my agency and wish will be considered secondary to minor comfort factors of cis people, and so that fewer people would see me as a woman, treat me as a woman, talk of me as a woman, include me as a woman.

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The future is ahead of us. We cannot know where it will go. I will hope that allies and friends and family will see me and my kin as what we are regardless of what symptom treatment options will emerge, and that together we will keep the meme of my more inclusive definitions of male and female, of sex and gender, active in at least the societies where I can live. Perhaps we will lose some parts of the world, like there are parts we have yet to gain. There are countries I cannot visit. There may emerge more. I particularly worry about the US and UK, though I also frequently am hopeful.

Throughout these worries I thought of a term for that space where I am acknowledged as who I claim to be. Whether this is only my own immediate sphere of myself, that of my kin, friends, family, colleagues, city, country, expanding forwards, this space is Aeaea. This space is the sanctuary I may inhabit because it, unlike what is outside, is not forbidden to me while I remain myself. No matter who denounces us, Aeaea remains, and is as large as we make it. Here we are welcome, here we are safe.