How the Washington Post/KFF poll represents underrepresented trans people

The Telephone Survey Support Center call center at NORC. At least fifty people are sitting in cubicles at computer workstations, holding pieces of paper.
The Telephone Survey Support Center call center at the University of Chicago National Opinion Reseearch Center.

I’ve been posting recently about the transgender survey released last year by the Washington Post and the Kaiser Family Foundation. Some of the things I write are critical, but I want to be clear how much I appreciate and value it as a real advance in understanding the situations and opinions of trans people in the United States. It’s a very big deal, because it really is the first representative survey of trans people in this country.

I’ve written extensively before about why representativeness matters in science, why transgender surveys are no exception, and how so many transgender surveys fail. So what does the Washington Post/KFF survey do that the other surveys don’t? As the researchers describe in their survey methodology report, they draw from representative panels.

Other studies have been unrepresentative because they relied on trans people responding to broadcast announcements (even in web forums), or surveyors reaching out to trans people they already know. These methods ignore several populations: people who might not be looking at those announcements, people who might not respond to a general announcement, and people who aren’t known to surveyors. That can exclude whole communities of trans people.

The Washington Post/KFF study draws on three existing panels that are built to randomly sample the population of the entire country. One, the AmeriSpeak panel from the National Opinion Research Center at the University of Chicago, uses something called “Address Based Sampling,” dividing the country into segments and sending letters to randomly selected addresses from each segment, asking them to participate in a panel. The others, the Gallup panel and the SSRS Opinion Panel, use a combination of Address Based Sampling and “Random Digit Dial,” where they call random phone numbers and ask people if they want to be on a panel.

The panels are groups of people, contacted through one of these methods, who’ve agreed to answer questionnaires. They’re paid a small amount, between $5 and $20, for every questionnaire they answer. In one questionnaire, the organization that runs the panel (NORC, Gallup or SSRS) asked them if they identified as trans; the Washington Post/KFF researchers don’t give the exact text of those questions. From these three panels, the researchers found 483 people who identified as trans, and then added 29 people from previous KFF surveys and three more, for a total of 515.

I have to note here that while you can pay people to answer questions like this, you can’t force them, in any ethical way. Similarly, you can reach people by mail and phone, but if people change their mailing addresses and phone numbers, they’re less likely to be able to join one of the panels.

These panels are not quite representative of the entire population of the country. Their answers can only be generalized to those people in the country who have stable postal addresses or phone numbers, and are willing to spend time answering surveys for NORC or Gallup or SSRS, for $5-20 each time. And the responses to this survey are not representative of all transgender people in the US, but of trans people with stable addresses or phone numbers who are willing to answer surveys.

It may sound complex, but I want to stress how much better this is than previous surveys. They didn’t post online or on a physical bulletin board and wait for people to respond. They didn’t buttonhole people who regularly visit LGBTQ service organizations. They asked people who had gotten literally random phone calls and letters from polling organizations and agreed to answer questions. They may well have reached trans populations that might be completely disconnected from the social networks that have answered previous surveys, and potentially less subject to peer pressure and groupthink.

I’ve already identified some conceptual problems with the survey, and I plan to discuss more, but I think this is a major advance, and it’s probably why the poll has some results that don’t fit with the typical picture painted by many trans advocates and previous surveys. I’ve already mentioned one finding: that 22% of respondents report that the transgender actions they’ve taken have made them at least somewhat less satisfied. I’ll talk about other findings that I think are worth highlighting. Honestly, I think it’s interesting that these haven’t been discussed more since this survey was released last March.

Previous posts about the 2022 Washington Post/Kaiser Family Foundation Transgender Survey:

What it means to be living

The author, wearing a dress with a white on blue floral pattern, a black sweater and gold-plated earrings and necklace, lifts a glass of prosecco to the camera
Is this living or what?

Recently I was talking to a friend about the question from last year’s Washington Post/Kaiser Family Foundation survey, “Has living as a gender that is different from the one assigned to you at birth made you (more satisfied) or (less satisfied) with your life?” She said, “but have you really lived as a woman?” Many trans people would bristle at the question, but for me it’s a valid question, and it gets to the heart of one of the conceptual problems at the heart of the survey. It also provides important context for interpreting the results.

The survey question is important because it fits into a debate: some people say they’re unsatisfied with the results of transgender actions they’ve taken. Some reactionaries have seized on this dissatisfaction as an excuse to impose restrictions on trans people. Some transgender advocates have responded by denying that anyone is ever really dissatisfied with transgender actions in any way worth discussing.

The issue is important to me personally, even though I would say that the transgender actions I’ve taken have overall increased my satisfaction with life. One reason I think I’ve been so satisfied is that I have paid attention to experiences of dissatisfaction that others have shared, and to my own dissatisfaction with the results of particular actions I’ve taken.

So have I lived as a woman? If you add up the days I’ve spent interacting with people as a woman over the course of my life, you might reach half a year. The hours I’ve spent as a woman in online communities, by message and now video, would probably add more than a year’s worth of interactions.

In that time I’ve had many of the negative experiences that women often point to. I’ve been catcalled and groped by men. I’ve walked in uncomfortable shoes, and had difficulty finding clothes that fit me well. I’ve avoided going places alone out of fear for my safety. I’ve also had good experiences, such as women welcoming me or showing they feel at ease around me.

But we’re talking about a survey, so how did the researchers at the Washington Post and the KFF define “living as a gender”? And this gets to one of the major conceptual faults with the survey. Immediately before the satisfaction question, they asked, “Currently, how much of the time do you physically present as a gender (such as a man, woman, or nonbinary) that is different from the one assigned to you at birth?” Here are the responses:

Option n %
None of the time 82 16 %
Some of the time 175 34 %
Most of the time 103 20 %
All of the time 155 30 %

The pollsters describe how they used this question to decide who to ask the following question about satisfaction with living as a different gender. 16% of respondents said that currently, they never physically present as a different gender, and the pollsters did not ask those 82 people the question about living as a different gender. I was assigned male at birth and currently I present myself as a woman some of the time, so if I were part of the panel I would have been asked about living as a woman.

Even more serious: the responses to the satisfaction question were used for the headline of the main article reporting the study: “Most trans adults say transitioning made them more satisfied with their lives.” So the researchers asked about “currently … physically present as a gender … some/most/all the time”, then presupposed that that meant “living as a gender” and reported it as “transitioning.”

I’ve written about the conceptual problems with “transition” before: there are some who argue for an expansive definition of transition, but in practice the concept is so overwhelmed by its prototype that when people hear the word, they tend to think of permanent, full-time, binary gender transition with major hard body modifications, including hormones and surgery. The Washington Post and KFF researchers did not ask respondents about that, they asked about current physical presentation, including “some of the time.”

The way the surveyors asked this question, it would be possible for a respondent to think they were saying that it felt good to wear on a leather jacket in their bedroom for ten minutes every few months, and that gets reported as “transitioning made them more satisfied with their lives.” That’s why in my earlier post on the topic I interpreted it as “satisfaction with transgender actions” rather than talking about transition.

I know people who manifest their gender in ways other than physical presentation. Those manifestations do have an effect on their social lives, and these people consider themselves to have transitioned, but they would not have been asked about living as a different gender.

Similarly, the use of the word “currently” is highly problematic. For most of three years (1999-2002) I rarely presented as a woman in public, because I lived in places where I judged the culture to be intolerant of fluid gender presentation. If I had been given this questionnaire then, I would not have been asked about my satisfaction with living as a different gender, because I was not “currently” presenting as a woman at all.

Did any of the 82 respondents who said they didn’t currently present as a different gender do so in the past? We don’t know, because the researchers didn’t ask them.

The issue with “currently” is a serious problem because there is a debate over people who physically present full time as a different gender, but then stop. This is often called “detransition.” Some people say they stopped presenting as a different gender out of dissatisfaction with the results of that action, others because they fear violence or discrimination based on their actions, and others say they simply decided to do something different.

The Washington Post/KFF poll could have shed some light on the motives of people who present as a different gender and then stop. But by adding “currently” to the question about physical presentation, they excluded anyone who might have presented as a different gender in the past from the satisfaction question.

Did the pollsters do these things intentionally? I doubt it. I think they had a particular idea in mind, the prototypical full-time, body-modifying transitioner, but they were aware that there are people who didn’t fit that mold, so they tried to make the questions flexible enough to cover those people.

I think the researchers underestimated how many people would turn out not to fit their preconceived idea of a transition. They discuss that in some of the articles they wrote about the survey results, but they realized that after they’d finalized the questions. I hope they get a chance to clean up those questions and run another survey soon.

Why people care about transgender satisfaction – and dissatisfaction

As I wrote recently, last March the Washington Post released a poll they conducted with the Kaiser Family Foundation. This was the first representative survey of transgender people in the United States, and it told us a bunch of interesting things about what it means to be trans in this country. In fact, the responses highlight some problems with the researchers’ concept of transgender, and suggest some ways the next survey could be better, but right now I want to focus on where this survey fits into the current political climate around transgender issues.

Over the past fifty years, people have acquired more rights to take transgender actions like wearing different clothes and changing official gender designations, and people and governments have shown more approval and respect for those actions. There has also been a negative reaction, and over the past ten years, right wing politicians have discovered that they can profit off of this reaction to bring in votes and donations. They have introduced a wide range of bills outlawing various transgender actions, and some of those bills have become law.

From one point of view, clothing, official gender designations and marriage are arbitrary, so why is this drawing such a strong reaction from some quarters? Much of it is the same reaction to any change in gender or sexuality, going back to Lot and Diogenes: visible non-conformity to rules of gender and sexuality are threats to the patriarchal power structure, and have the potential to reduce birth rates, which many nationalists see as a source of power.

There are also some parents who are terrified of their children’s growing autonomy. They panic when they see their kids taking on new names and pronouns, and maybe making new friends that they don’t know.

There are some women who find power and safety in what they think of as all-female spaces. They feel threatened by anything they perceive to be an intrusion by men or boys, or an abandonment of those spaces by people they see as women and girls.

There is a certain cost that people face in accommodating other people’s transgender actions. At a minimum there are changes in paperwork and getting used to different names and pronouns. Some transgender actions, like hormone treatment or surgical procedures, have a significant cost, and many trans people want those costs to be paid by the government, or by private health insurance offered through employers.

You might have noticed that the reactions I described above are largely from people who aren’t doing transgender things, feeling threatened by people doing trans things. As a trans person I can roll my eyes at them, but they’re important to acknowledge, because they’re often the real motivation, disguised with a false concern for trans people.

What about the risks to actual trans people? They fall into four broad categories: irreversible changes, financial, safety and opportunity costs.

The first is that many of these transgender actions – particularly “hard” body modifications like surgical procedures and hormone prescriptions, but even official gender designations or the public pronouncements someone might make about their gender and/or sexuality – are difficult or even impossible to reverse. Some of them, particularly surgical procedures, come with risks that are widely known, but that may be downplayed for various reasons.

There is simple monetary cost: the costs of hormones and surgery I described above, but also hair removal, hairstyling and clothing.

Then there is a meta-threat that is kind of difficult to articulate: it’s that if people are allowed to take these transgender actions then we’ll be subject to discrimination, harassment and violence. Some people seem to use that threat to justify subjecting others to discrimination, harassment and violence, which is an incoherence on the order of “the beatings will continue until morale improves.”

Finally, there is an opportunity cost. Some transgender actions can take a lot of time, energy and focus, which is not available for other activities like hobbies. It may even take away from exercise, relationships, and work.

Over the years, many trans people have reported that they’re dissatisfied with the results of certain actions they’ve taken, particularly ones that are difficult or impossible to reverse, like “hard” body modifications, but also about the financial and opportunity costs, or the cost of retaliation by others. Some people take an extreme position that it was all for nothing, but many people say that the benefits of these actions simply didn’t justify the costs.

Of course, this dissatisfaction and regret has been weaponized by the non-trans actors I described above: insecure parents, certain kinds of feminists, and right wing politicians and activists. Some may be genuinely concerned, but often it is clear that they are simply using these trans people to attack other trans people.

In reaction, many transgender advocates have staked out their own extreme positions, downplaying or even denying any dissatisfaction with transgender actions. Some advocates have attacked the character of individuals who have reported dissatisfaction. Others have pointed to surveys that report little to no dissatisfaction, but many of these surveys rely on unrepresentative samples, so there is no way to rule out the possibility of sampling bias.

As I understand it, this is a primary goal of the Washington Post/KFF poll: to shine some light on the issue by asking a representative sample of Americans who’ve taken transgender actions whether they’re satisfied. Here are the responses to the question “Has living as a gender that is different from the one assigned to you at birth made you (more satisfied) or (less satisfied) with your life?”

A lot more satisfied 45
Somewhat more satisfied 33
Somewhat less satisfied 17
A lot less satisfied 5

As I discussed in my last post, I would answer this question as “A lot more satisfied” as well. The Washington Post and KFF researchers consolidated the satisfied and unsatisfied responses to report the total as 78% satisfied, and used this for their headline, Most trans adults say transitioning made them more satisfied with their lives. Again, there are conceptual problems with this question, but I think it does show, broadly speaking, that the vast majority people who take transgender actions tend to be satisfied with the results of those actions.

But let’s take a minute and focus on the 17% (73 respondents out of 427) who said that living in a different gender from the one assigned to them at birth made them somewhat less satisfied with their lives, and the 5% (21 respondents) who said it mad them a lot less satisfied.

These are not the tiny dissatisfaction percentages trumpeted by many advocates. This is almost a quarter of the people who reported that they lived in a different gender from the one assigned to them at birth. It doesn’t mean people shouldn’t take transgender actions, but it does mean that we need to be careful about which actions we take, when we take them, and how.

In order to make good decisions, we need to know what can go wrong, and what can make for an unsatisfactory experience. That means that we need to listen to the people who are dissatisfied, and hear their stories. It’s not all about the backlash.

A big reason that my experience with transgender actions has been so satisfactory is that I heard some of those stories of dissatisfaction and regret before I ever seriously considered taking any actions. Informing myself and being careful about my actions has helped me avoid doing some things that I think I would have regretted.

Has living as a gender that is different from the one assigned to you at birth made you more satisfied or less satisfied with your life?

The author at age 25, after the New York City Pride Parade, wearing makekup, earrings, padding, a leotard, a vest, a rainbow flag pin, and "women's" cut corduroy pants.

Has living as a gender that is different from the one assigned to you at birth made you more satisfied or less satisfied with your life?

That is the topline question from the first representative survey of trans people in the United States, released in March of this year by the Washington Post and the Kaiser Family Foundation. The answers formed the main headline the Post ran about the survey:

A lot more satisfied 45
Somewhat more satisfied 33
Somewhat less satisfied 17
A lot less satisfied 5

In general I like this survey. I’ve got a number of thoughts about it, but I wanted to start by answering this question for myself: has living as a gender that is different from the one assigned to me at birth made me less satisfied or more satisfied with my life? I would have to say a lot more satisfied.

The biggest reason is that it helped me to find love. In 1996 I met up with some friends to watch the New York City Pride Parade. There was one friend of a friend who I had met at a party the year before. We lived near each other in Brooklyn and our mutual friend had already tried to get us together. Her reaction was “that annoying guy who went to Chicago?” and mine was that I didn’t remember her.

When I went to the parade, I wore make-up, jewelry and women’s clothes. She and I rode the subway back to Brooklyn, and we exchanged phone numbers. One thing led to another, and we’ve pretty much been together ever since. We’ve been married for almost 24 years and have a kid who’s now all grown up.

When this woman first met me, she saw me as just some annoying guy. When she spent time with me as a woman, she was more impressed and opened up to me more, and then I noticed her. Would she have been interested in getting to know me better without meeting me as a woman? It’s impossible to know – she says that maybe just seeing me at the Pride Parade would have been enough – but I had had limited success in dating up to that point.

In more superficial terms: when I was little, I admired a lot of things that girls wore (dresses, tights, barrettes) and things that they got to do together (dance, cartwheels, jump rope). I was told that I couldn’t take part in those things, and it all felt very arbitrary to me. By the time I felt comfortable enough to physically present as a woman in public I was too old for cartwheels and little-girl dresses, but I’ve been able to participate in some age-appropriate feminine practices, which has made me more satisfied with my life.

A bit less superficially: when I first started trying girlish things, I had been told very clearly that it was inappropriate, so I kept it secret for years and lived in shame. When I was in my twenties I decided to come out of the closet, but for many years afterwards I was afraid of being shunned or discriminated against, so I still avoided talking about my gender expression to some people. For just the past ten years I have been out to more people in my life, and that has made me much more satisfied.

There are also downsides to living as a woman, as most people who have done it will tell you, and downsides to living as two different genders over time. Owning two wardrobes, or a wardrobe and a half, is expensive. I have sometimes wanted to grow a beard or moustache, but I’ve felt that growing any kind of facial hair is not consistent with the feminine presentation I want.

I have no evidence that anyone has discriminated against me for being trans, but it may have happened. I have been denied services because people saw me as not trans enough, or not the right kind of trans. But overall I feel that living as a woman has made me a lot more satisfied with my life.

You may be able to tell just from reading this that I found some of the words chosen by the Washington Post and KFF researchers to be problematic. I’ve got a lot more to say about this, starting with the political context of this question, but I felt that it would be best to start by focusing on this question and what it means to me.

Talking about trans without getting stuck

A colleague recommended an interview on the French History podcast with Rachel Mesch, who is Professor of English and French at Yeshiva University, on her new book Before Trans: Three Gender Stories from Nineteenth-Century France. Since I’m trans and I’ve been studying nineteenth-century French literature, it’s right up my alley!

Of course, the big thing I noticed was that Dr. Mesch and podcast host Gary Girod kept getting stuck in the muck of categorizing people. Mesch profiled three nineteenth-century authors who were assigned female at birth, but presented a masculine identity to the world at times in their lives. Were any or all of the three authors transgender? Were they women? Were they men? Were they feminists? Were they gay? Were their husbands gay?

As my colleague knows, I’ve argued that categorizing people is almost impossible and tends to cause more problems than it solves. Transgender issues become so much more understandable if we stop trying to categorize people and instead talk about feelings, beliefs and actions.

On the level of actions, Mesch makes it crystal clear: Jane Dieulafoy and Rachilde not only dressed in men’s clothes of the period, but obtained an official “permission de travestissement,” which apparently was only a thing for people assigned female. Rachilde and Marc de Montifaud wrote under male identities. In terms of beliefs, also, Mesch tells us that Rachilde wrote that she didn’t think of herself as female.

Mesch describes how all three authors wrote about the three major transgender feelings, as experienced either by themselves or by their fictional characters: gender dysphoria (when a person feels discomfort living in their assigned gender), transgender desire (a desire to live as a different gender from the one assigned at birth) and gender fog (an intense excitement connected to the anticipation, experience or memory of transgender actions).

In terms of gender categories, I’ve argued that it makes much more sense to treat “woman” and “man” as radial categories in the tradition of Wittgenstein (1953), Rosch (1973) and Lakoff (1988). Were Dieulafoy and Rachilde men? I’m guessing their tailors appreciated the business. Were they women? They were ineligible to vote. You can go on to various contexts where the categories mattered in their lives, and you can apply the same principles to the categories of “feminist” and “gay.”

Mesch describes her own conscious decision to refer to all three authors consistently with “she” pronouns, but as a linguist what I’m interested in is the gender of the pronouns and adjectives they use to refer to themselves. In particular, Mesch tells us that people regularly wrote to the two masculine pseudonyms of de Montifaud, Marc de Montifaud and Paul Erasme, under the impression that they were writing to someone who hadn’t been assigned female at birth or lived as a woman. I assume that when writing under those two identities, de Montifaud used gendered language consistent with their masculine names.

What I’m curious about is whether de Montifaud or the other two authors used masculine gendered adjectives or pronouns to refer to themselves when addressing people who knew they had been assigned female at birth and raised as women, and if so, at what points. Mesch did not address this in the interview, but she may in the book.

Mesch tells Girod that she felt a bit apprehensive writing about people who she considers to be transgender in some sense without identifying as trans herself. From the interview it sounds like she did a very respectful job. I’m sure some trans people will object to her use of “she” pronouns for the authors, but otherwise I didn’t hear much to object to.

One area where not being trans may have held Mesch back is in her respect for the dominant narratives in trans politics. As a trans person it’s easier for me to challenge those dominant narratives than it is for Mesch who needs to show respect for trans culture. Slightly easier, at least.

One way that it’s important to challenge those dominant narratives is in their insistence on categorizing people: as trans or not, as men or women or nonbinary. One of these narratives is that in the past people were confused about trans stuff and had weird categories. Often these categories were imposed on trans people by outsiders who hated or patronized us. Now we have these categories for people, and things are finally right with the world.

Mesch does not challenge this view of progress, and as she describes the ontological struggles that some of these authors went through as they tried to fit themselves into their view of the world, she seems to imply that they would have had an easier time if they had our 2020 categories for gender and sexuality available to them.

Sadly, as a trans person who’s lived through the past thirty years of categorization debates and who regularly talks to people dealing with trans feelings, beliefs and actions, I don’t see any evidence that people these days find it easier to understand what’s going on with their lives. As a scholar of the nineteenth century I’m sure Mesch knows that historical progress is rarely linear, and sometimes it goes backwards.

In this post I’ve already argued that the dominant trans practice of categorizing people is hugely problematic. I’ve laid out my own alternative practices, but it’s possible that the systems used by the authors Mesch studied were in some ways superior to the system she was taught, and even the one I’ve articulated.

A final note: Mesch says that “it was hard to find people who are French historians or French literary scholars who felt really that they knew trans studies enough to speak to these issues.” It’s been hard for me to be recognized as a scholar of French literature, language or history, or of trans studies. Like many people, I worked hard to get a doctorate and taught as an adjunct professor for years. I applied for many full-time jobs, and didn’t get called for a single interview. So now I work as a web developer.

If we really want to be able to find knowledgeable trans scholars, we need to give them work. And that may mean hiring a trans scholar instead of someone you went to grad school with, or yet another student of that famous scholar, or someone with a degree from a fancy university.

In Colorado, lots of trans teenagers think of suicide

The Colorado Department of Public Health and Environment conducted a Healthy Kids Colorado Survey in 2015. Ann Schimke of Chalkbeat reports that the survey shows that transgender teenagers in the state are more likely to plan or attempt suicide than their non-trans classmates.

Unlike some surveys, this is based on an actual sample of 15,970 high school students in Colorado, with a 46% response rate. 2.2% of the kids (162) said they were trans, and 1.6% (118) said they were questioning their gender. 35% (57) of the trans kids said they had attempted suicide, and 14% (16) of the questioning kids said they had.

The reported rate of attempted suicide for the other kids is 7%. That’s 53 more high school kids in Colorado who say they’ve attempted suicide than would have if they hadn’t been trans.

I’ve got more thoughts on suicide, but the biggest thing is that we need to work on accepting kids who are trans. That doesn’t necessarily mean any body modifications. Just accepting would make a huge difference. I say that from experience.

The Power of Glamour and transgender feelings

Seven years ago I talked about the notion of glamour as described by Virginia Postrel. Virginia has been working on a book about glamour, and it was published on Monday. Here’s the definition from the book (as of last year):

Glamour is not the same as beauty, stylishness, luxury, sex appeal, or celebrity. Glamour is, rather, a form of nonverbal rhetoric, which moves and persuades not through words but through images. Glamour takes our inchoate longings and focuses them. By binding image and desire, glamour gives us pleasure, even as it heightens our yearning. It makes us feel that the life we dream of exists, and to desire it even more. We recognize glamour by its emotional effect—a sense of projection and longing—and by the elements from which that effect arises: mystery, grace, and the promise of escape and transformation. The effect and the elements together define what glamour is.

The Power of GlamourYou can probably see why I was immediately struck by the connection to transgender feelings. My strongest trans feeling is that longing to escape from my male reality, with its career obligations and social frustrations, where I’m expected to go out and get what I want, into a dream world where all I have to do is put on the right clothes and everyone will pay attention to me, desire me, and give me what I want. (Yeah, right!)

To me, glamour explains the connection between gender dysphoria, my feeling of unhappiness with being a man, and gender desire, my desire to be a woman, to be seen as a woman. There are lots of men who are unhappy being men, but only some of us want to be women. Glamour helps us understand why we do.

As Virginia has pointed out, this is compatible with the Official Trans Narrative: if you have an innate sense of gender that doesn’t match your physical sex, then you’re likely to be unhappy and thus feel a desire to escape your birth gender classification. But for those of us not convinced by the innatist narrative, glamour opens the door to other explanations.

Since then I’ve followed Virginia on her blogs and on Twitter, and in June she mentioned that she visited my blog while checking footnotes. On Monday night I had the pleasure of meeting her in person at the book launch party, and found that I’m quoted on Page 63, connecting glamour with despair:

I came to the idea of despair based on Virginia’s characterization of glamour as a means of escape. If you’re trying to escape through a fantasy you have to be pretty desperate, right? That’s the sense of “despair” that I mean – a feeling of being trapped and having no options left.

To Angus/Andrea with thanks & best wishes - Virginia

That’s from a comment I left on an article Virginia wrote in 2008, expanding on the connection Salman Rushdie made between terror and glamour. In the book, she expands on my connection to despair by noting the glamour elements highlighted in the documentary Paris Is Burning.

The glamour response is powerful. It can move us to approach strangers, to buy houses, and to blow up buses full of people. It can also move us to cross-dress, to get surgery to change our bodies, and to declare gender transitions.

What I’ve read of the book so far has been great. I encourage anyone who’s interested in transgender feelings to get a copy. I’ll be posting more about it in the future.

Good research: Three trans communities in New York City

In November I was annoyed with a couple of statements by Sel Hwahng, but after re-reading this article he co-authored with Larry Nuttbrock, I’ve decided that it’s really solid research and should be read by anyone who’s interested in public health – or trans politics in general.

The Silver Swan, a popular hangout for “White cross-dressers” in the mid-00s.

As I discussed in my earlier post, several years ago I participated in a study where I went to a storefront every month or so, gave a blood sample, and talked with a researcher for a while. Usually it was a fairly repetitive series of short-answer or Likert questions, but there were a few discussions that were more open-ended. Larry Nuttbrock was the principal investigator on the study, and I’m one of the “White cross-dressers” that he and Hwahng are talking about.

Re-reading the article, I see that it was really only two lines that bothered me:

These cross-dressers explained that because of their desire to maintain a traditional masculine gender role and hide their transgender status, they often did not undergo transition, hormonal supplementation, or surgery until well into their 40s or 50s. Transition often occurred after a domestic breakup, when they could be more out as transgender.

It was definitely true that some of us really wanted to transition but felt trapped by commitments to work and family, but not all of us by any means. I personally decided that I didn’t want to transition years before I got married and had a child, and I haven’t changed my mind about it. Most of the other people I met in that scene showed no interest in transitioning. But this is relatively minor.

Judging from media reports and health research, you might think that the trans population is either all HIV-infected prostitutes or all sexy young transitioners. I schlepped down to Avenue A every month and got pricked with a needle so that people could see another way to be trans. Hwahng and Nuttbrock show that here in New York there are at least three ways to be trans. They found that life was very different for us White cross-dressers than for Asian sex workers and members of the House Ball community.

According to Hwahng and Nuttbrock, House Ball members, almost all from Black and Latin American backgrounds, were more likely to engage in survival sex work and to have little power to refuse sex or to insist on condoms. Members of my White cross-dresser community were largely able to avoid sex work if we chose, so “when White cross-dressers did engage in sex work, it was almost always for recreational purposes.” The Asian sex workers in the study had an intermediate level of power, often being able to insist on condoms and working in hotels and apartments instead of on the street.

Given these different circumstances, it’s sadly not surprising that our risks of HIV infection are vastly different. In another paper co-authored by the entire study team, they didn’t have enough data about the Asian sex workers, but they reported that “HIV was 3.5% among Caucasian Americans compared to 49.6% and 48.1% among the Hispanics and African Americans.”

It’s important to note here the limitations of the study. Nuttbrock and his colleagues were able to investigate these three trans communities, but they were aware of others:

The study also identified additional groups, including the following: low-income, immigrant Latina(o) sex workers of Central and South American origin who solicited in Queens; low income, immigrant Latina(o) sex workers who solicited in Manhattan; and low-income, immigrant South Asian transvestites in Manhattan, Queens, and New Jersey. Not enough data had been gathered at this writing, however, for detailed analyses of these other populations. Some study participants did not fit any of these ethnocultural contexts but did not constitute large numbers and were thus considered outlier data.

This is really key. We don’t know what we don’t know. There could be some population of wealthy South Asian transvestites that completely swamps all three of the other groups numerically, but that was invisible to Hwahng and Nuttbrock because they meet in secret in luxury condo towers. Not that likely, but nobody really knows. I’ll close with a great quote from the report:

To understand the complex, interlocking behavioral and sociostructural determinants of health that often remain hidden within the geographic location of the New York City metropolitan area, it is thus imperative to examine as many divergent ethnocultural transgender communities as possible.

Good research of the month: “coming out” in trans communities

As you could probably tell, I feel bad describing research like the Trans Mental Health Study in such strong negative terms. I know that the authors wanted to do something to help the trans community, and they thought that was what they were doing. I want to balance that out by highlighting examples of transgender research done right.

I recently had the pleasure of meeting Lal Zimman, a fellow linguist who studies transgender language. In 2009, Zimman published a paper (PDF) summarizing his research into the concept of “coming out” in transgender communities.

A.C. Liang (1997) and Kathleen Wood (1997) reported on “coming out” stories of gay men and lesbians. In these stories, the term “coming out” is used to refer to the sharing of a sexual orientation. Because this orientation may not be visible, Zimman says, “Liang argues that reference to the ‘processual’ nature of coming out – in other words, the fact that coming out is not a single event but is rather reenacted time and again throughout an individual’s lifetime – is a crucial component of the coming out narrative.”

Zimman interviewed nine individuals who had completed a gender transition and found a pattern that will probably be familiar to a lot of you. They used “coming out” to share a transgender identity, but in one of two specific ways that were very different from those reported for gay men and lesbians. Those who hadn’t transitioned to their target gender used “coming out” to mean a declaration (in Zimman’s terms) of their desire or plans to transition to a different gender. Those who had transitioned used “coming out” to mean a disclosure of their history of gender transition.

This is the right way to do research on an unrepresentative sample. Ask relatively open-ended questions and listen to the answers. Note common threads among the answers. Use the stories to make existential arguments – ones that highlight the existence of something that may not have been acknowledged by the academic community. This is particularly valuable to show exceptions to generalizations that others have made. In this case, Zimman identifies exceptions to the generalizations that Liang and Wood made about coming out narratives.

Even though I think Zimman’s research is exemplary here, I want to note that I have a verbal hygiene argument with what he found. I don’t like these uses of the term “coming out,” and I think they’re bad for both the trans community and the wider LGBT community. But that’s a topic for another post. In the meantime, keep studying trans communities!

My life as a data point

I came across this quote in the abstract of a conference presentation by Sel J. Hwahng (on Page 7 of this PDF):

It is well known among public health researchers that in the U.S. the majority of male-to-female transgender (transfeminine) people are low-income people of color, while the majority of female-to-male transgender people (specifically those that identify as transmen, FTM, or genderqueer) are white and economically/educationally privileged.

I was floored by this statement, since I’ve been very adamant about the fact that we just don’t know what the majority of anything trans is, and about the need for caution when making any kind of statement involving proportions. The statement goes against my own perceptions, but I deliberately avoid reading too much into my own perceptions, because I know how much I don’t know. If this non-fact is “well known among public health researchers,” then my opinion of public health researchers just dropped quite a bit.

I was further intrigued to discover that I’m in those numbers. Me personally, I’ve been counted! Several years ago I volunteered for a multi-year study of male to female transgender people in the greater New York area. Every few months I’d go in, answer a bunch of questions, and get a blood test and a few bucks for my trouble. I didn’t do it for the money, which was well below my hourly rate for computer work. I was contributing my data, in part to provide a counterpoint to the idea that all transfeminine people are low-income people of color. I guess it only goes so far.

It turns out that Sel Hwahng was one of the researchers. I might have talked to him once or twice, but I mostly dealt with Mona Rae Mason and Monica Macri. And yes, non-Hispanic white people counted for only 27% of study participants and people making more than $30,000 a year were only 26%, so us well-off white people are certainly a minority of the study participants. No, you can’t generalize from that, but then again I didn’t really talk sampling with anybody while I was there.

Reading that abstract got me looking up the results that have come out of the study. Sel Hwahng used some of the qualitative data in this report from 2007, showing how the MTF trans population in New York is segregated into distinct communities based on ethnicity: black/latin, asian and white. It’s got a lot of interesting existential observations, but I could do without the implication that all of us “middle-class White cross-dressers” are just waiting to break up with our wives to transition. Some of us plan to die as men.

In 2009 the whole group published a report using the quantitative data to argue that life for transgender people is more complicated than Ray Blanchard’s simplistic “homosexual” and “autogynephilic” dichotomy. They then got into a thing with Anne Lawrence about it. What I find most interesting is that among the study participants were 221 people who reported that at some time in our lives, wearing feminine attire was “sexually arousing,” including 90 who reported not being attracted to non-transgender females, and 58 who reported not being attracted to non-transgender males. One of those 58 is me.

In 2011 the group published another report based on questions about verbal and physical abuse, and whether such abuse was related to gender identity or presentation. They showed that MTF transpeople who experience that kind of abuse tend to be more depressed, and also to have more unprotected anal sex, and to be at greater risk for HIV infection. I’m glad to say that I didn’t have any abuse, depression or unprotected anal sex to report, and I didn’t test positive for HIV. I’m sad to read that there were 107 people who came in and told Monica or Mona that they’d been verbally or physically abused, 145 who were depressed, and 43 who had unprotected anal sex with a casual partner or a john. The point of the article is that one way to overcome AIDS is to stick up for transpeople, and of course that’s a message I support.

The 2007 report makes unsupported leaps even without explicit quantitative statements, but in the 2009 and 2011 reports, Larry Nuttbrock was very careful to include disclaimers about the limits to generalizing the results. I’m glad he did, and I think his conclusions were mostly justified. Overall, I’m satisfied with the reports that have come out of this study. It was an interesting experience to answer all those questions. I wonder what they’ll do next.