Becoming women: Transgendered identities, psychosexual therapy and the challenge of metamorphosis.
May, K. (2002). Becoming women: Transgendered identities, psychosexual therapy and the challenge of metamorphosis. Sexualities, 5(4), 449-464.
This article is authored by a woman who practices as a psychosexual therapist in the UK’s National Health Service (NHS), and it is a critique and analysis of the way transgender or transsexual individuals’ needs are viewed and treated by medical professionals. Her concerns center around the conflict between “fluid, performative notions of gender identity” and “preoccupations with a more rigid stability of gender identity” (450). May describes a client’s desire for acquiring a body which is “coterminous with the lived-in gender,” as well as their preparedness to live with potential gender ambiguity (450). Both affect the “provision and delivery of medical and social support services” (450). The author argues that transpeople are too often refused certain available choices which will enable them to obtain the outward identity they hope to achieve, as “the very medics who stand between transpeople and [their new identity]…[do not keep] pace with the recently evolving debates, which incorporate more processual ways of conceptualizing gender” (451).
The author states that transpeoples’ “refusal to comply with pre-set categories…[and] insistence on an engaged politics which privileges ambivalence, irony and paradox…summarize a stance that medical discourses seem not only unable to recognize, but are highly likely to outlaw and pathologize” (451). Furthermore, from personal experience working with the health service in the UK, and with citation and analysis of relevant medical and psychosexual literature, May insists that the only recognized view of a gender dysphoria with which medical professionals and discourses seem comfortable, is “one within which a dependent client needs the skills of surgeons and endocrinologists in order to re-align mind and body” (451). The author calls for a move away from the hegemonic duality of two sexes and two genders and supports a rethinking of the categories of sexuality and gender in favor of a “gender transcendence theory in which gender categories are no longer linked to biological sex” (453). The common personal struggles of individuals seeking to achieve a new sexual identity or gender in the face of medical professionals unwilling to facilitate a metamorphosis are outlined. The author is concerned that the focus of whether or not surgical intervention should be encouraged continues to be placed on, “‘passing’ (i.e. on being seen as gender-appropriate and therefore ‘unnoticed’ in public venues)” (453). May reflects on her own experiences with clients who identify as transgendered or transsexual, and discusses personal behavior and views during therapy which become problematic and threaten her clients’ performance of their identity. For example, she writes, “on the one hand, I am looking for conforming gender-specific behaviour, whilst on the other, registering a discomfort with clients’ keenness to identify with stereotypes of womanhood which I am unable to relate to. The choice of transsexual clients to become a ‘not-like-me’ woman must be a factor in any reluctance on my part to see them as a real woman” (457).
In her conclusion, May identifies specific changes in attitude and perception that must take place before transsexual and transgendered individuals can be accepted and regarded properly in society. First and foremost, the author calls for a “framing [of] gender identity as creative, rather than given” (461). In terms of the medical or psychotherapeutic management of these queer bodies, the author suggests that, “the first necessity, via training and professional bodies, is that practitioners become aware of the debates,” and participate in a, “shift in awareness from conceptualizing transsexualism as a unidirectional passage from one gender to the other…to an understanding which allows for and incorporates… gender ambiguity and gender contradiction” (461). This article is important in that it highlights the ways in which the sociology of medicine and mental health has complicated various medical approaches to transpeople as patients and their unique or individual needs. The author unveils the highly problematic nature of contemporary medical and psychotherapeutic professionals to define, group and treat transpeople according to conventional methodologies rooted in essentialism. As such, the risks and threats transpeople perpetually face when entering clinical or therapeutic settings are attributed specifically to medical practitioners or therapists who refuse to recognize the plurality of sexuality and gender identification in society today. The article takes a radical stand against traditional medical and psychotherapeutic discourse surrounding transsexual and transgendered individuals, and advocates for positive changes to treatment and therapy through new approaches of educating and training professionals in the field.