Monthly Archives: April 2015

Transgender Terminology in Psychiatry

The psychiatry community does not accepted the terminology used by the transgender community. Instead of using male and female to classify people by gender identity, they insist on using the terms to classify people by the state of their genitals.

This is one of the reasons why the transgender community is being systematically hurt by the psychiatry community. Essentially, their terminology implies that without genital surgery, transwomen are men, transmen are women, and erases the existence of nonbinary people.

Until the psychiatry community accepts the right terminology, they cannot accept the gender identity of trans people. Many psychiatrists have harmed the trans community in various ways, and there is pervasive distrust of psychiatrists among trans people. Essentially, most trans people regard psychiatrists as gatekeepers who need to be conned with stereotypical trans narratives, and bribed with consultation fees to allow them to transition, and most psychiatrists deserve neither the trust nor the money of trans people.

Changing terminology is a big issue, especially because the psychiatry community is part of the community of doctors, and the trans community does not have much representation within the community of doctors. But this step is essential if the psychiatry community and the trans community are to work together, and have a relationship based on trust rather than on gatekeeping and misrepresentation.


Coming out as transgender

Here are some tips for coming out as transgender. I’ve listed only stuff that are usually not covered in the other guides on the internet. These are biased towards my social circle, modify them as required.

  1. If you are the weaker person in a power imbalance, for instance a chronically abusive environment, the fix the power imbalance before coming out. Why? Because the more power you have at your environment, the less likely you are to face abuse on coming out.
  2. For coming out to any group of people, like family/work/etc., instead of coming out to them all at once, come out to them individually in private, and ask them to keep it a secret. Once they’ve had enough time to digest the information, come out to the group as a whole. Why? This will allow you to control their reactions, and prevent the group from ganging up against you.
  3. Start early, and come out gradually. Start by coming out as gender dysphoric, and say that you are seeing a professional for it. Gradually discuss what you plan to do about it, maybe passing your plans as the professional’s recommendations. Even if you plan to present as your actual gender, do not reveal this too early. Why? People are generally more accepting of things that they’ve had more time to process.
  4. If you are doing hormone therapy, hair removal, etc., maybe start it before coming out to parents/colleagues. Why? If you establish an androgynous look, people think that you will cis-pass easily, they will usually be more accepting of you.

If you’re okay with sacrificing some authenticity for acceptance, here are a few more tips. I’ve separated these out as they are triggering or otherwise unacceptable to many trans people, as pointed to in the first comment.

  1. Do not come out using the word “transgender”, use the word “male” or “female” instead. Why? Because the word “transgender” has very negative connotations for a lot of people. For instance, many people think that trans people are sex workers, and that sex work is evil, therefore trans people are evil. Also, a common misconception is that all transgender people belong to a gender outside of the male/female binary, which is a problem for binary trans people.
  2. If you are nonbinary, consider coming out as binary transgender instead. For instance, if you are male-assigned, come out as female. Why? Because many people are not aware of nonbinary genders, and will be more accepting of binary trans people than of nonbinary people.
  3. If you are coming out as nonbinary, prefer “they” as nonbinary pronoun. Why? “They” is the most widely accepted nonbinary pronoun. You will probably get better results asking for they/them pronouns, rather than your preferred pronouns.