Trigger warning: mental health and themes of suicide.

For a start, I’ll state clearly that I’m not a doctor. I’m a scientifically literate lay person. The purpose of this article is to address common misconceptions about trans people and transness.

The first myth is that transness is a mental illness. In and of itself it’s not. It’s more like a difference between mind and body. It can lead directly to mental discomfort or mental illness, but those are one step further down stream. The actual state of being trans is not pathological. Trans minds are minds that more closely resemble those of their gender identity than the gender assigned to them at birth. This can be seen in brain scans early in life. It’s not typical, but maybe one in a hundred minds is like this. And gender is in the mind. It should not be confused with the systems and processes that lead to development of either primary or secondary sex characteristics, such as genital formation or facial hair. Transness is something we can and should support with gender affirming care (GAC), just as myopia is supported with corrective lenses or eye surgery.

The pathology only rears its head in trans people when gender affirmation doesn’t occur. GAC can be anything from a name change or hair cut, through to hormone therapy and genital surgery. It starts with social GAC, such as coming out, altering presentation to better match gender, and asking people to use appropriate pronouns and names.

If the person is prepubescent or pubescent they might want to go on puberty blockers, in order to avoid developing traits that are only altered with difficulty, or can’t be altered at all. There are drawbacks to puberty blockers. They can affect growth and bone density, but given that teens denied gender affirming care are much more likely to attempt suicide, and the side effects aren’t severe, the trade-off is sound. US states that recently legislated against trans youth saw suicide attempts by trans youth increase by as much as 72%. This kind of outcome far outweighs possible slowing of bone development or growth, and once puberty blockers are removed the process of puberty resumes. Cis kids are given puberty blockers to treat certain issues too, but this is generally ignored when anti-trans arguments arise.

Trans youth are not subject to other, more drastic medical GAC ad hoc, as anti-trans rhetoric claims. Children are not given surgical treatment to affirm gender, and the only endocrine intervention is going to be puberty blockers, until a level of maturity is reached. That’s the whole point of blocking puberty until they grow up enough. If puberty blockers have been used, much less surgical intervention is going to be required. For example, a trans girl assigned male at birth, who has blocked puberty, is not going to have formed the masculine face structure that is commonly treated with facial feminisation surgery (FFS) in older transitioners. Trans boys won’t be as likely to need top surgery if puberty has been blocked early enough, either. The fewer surgical interventions, the better!

If GAC is not given, people may experience gender dysphoria. Please note that I don’t only refer to GAC for trans people. The most common surgical GAC is breast reduction surgery for cis men. Yes, you read that right. Men who aren’t trans are the largest demographic to receive such care. It’s used to treat the gender dysphoria cis men experience when they develop breasts. Gender dysphoria can lead to depression, suicide ideation, suicide, and other serious outcomes, so it’s important to treat it in everyone, be they cis or trans.

Further anti-trans rhetoric claims that trans women have an unfair advantage over cis women in sports, but the outcomes don’t bear this out. By rights, given that trans women have been openly competing in women’s events for decades, we should see them winning at least as much as cis women, but we don’t. Further, a 2024 study, cited in the previous link, even found that trans women are, to some degree, disadvantaged:

• Transgender women performed worse than cisgender women in tests measuring lower-body strength
• Transgender women performed worse than cisgender women in tests measuring lung function
• Transgender women had a higher percentage of fat mass, lower fat-free mass, and weaker handgrip strength compared to cisgender men
• Transgender women’s bone density was found to be equivalent to that of cisgender women, which is linked to muscle strength
• There were no meaningful differences found between the two groups’ hemoglobin profiles (a key factor in athletic performance)

The problem with demonising trans women is that they aren’t the only ones adversely affected. The misinformation of the “trans threat” also results in the policing and violence against cis women. A woman has only to fail to live up to current feminine beauty standards to be subject to harassment, violence, and violation by those riled up by anti-trans rhetoric and other hateful people. Cis athletes, and cis women and tomboys using public women’s spaces have experienced this, and it will only get worse while the unreasonable vilification of trans people persists. Recently a cis gay man was harassed in a men’s bathroom, for being gorgeous, because the transrage furore has lead people to believe they can police others for looking different to them. It’s a very disordered and antisocial way to live. It comes across to me as much more pathological than being trans, in fact.

This is by no means comprehensive. I just wanted to cover a few myths that get trotted out all too often. Let me know if you’d like me to tackle any more of these. I’m zerodotenzed on both Threads and Instagram.