The history of gender variance

Workers’ Liberty strongly supports trans and gender diverse (TGD) people’s rights, while some on the left see TGD activism as threatening women’s “sex-based” rights. This is the first of a series of articles in which I will attempt to thread a path within this hostility about TGD politics; to look for ways that left-wing activists can work toward more agreement on how to fight for the rights of this oppressed minority.

This article outlines the history and origins of gender variance. Future articles will examine political polarisation around TGD people; biological and social materiality, TGD and women’s rights; and socialists’ attitudes to oppression.

I’ll use “assigned sex at birth” to talk about biological sex characteristics, and “gender identity” for how people identify psychologically and socially. My academic background is sociology of science around TGD people, I work at a university General Practice department and a gender-affirming health care clinic, and identify as a gender-non-conforming man. I am writing on my own behalf and nothing here represents the stance of my employers.

Early age

People develop a gender identity by around the age of three, which seems consistent across very different cultures, including ones where ascription of gender stereotypes and gender roles to young children was much smaller than it is in capitalist societies today. For most people, our gender identity tallies with our perceived sex and gender assignment at birth. However, there have always been gender-variant people who from an early age feel a gender identity not tallying with that ascribed to them at birth (recent estimates are around 0.5% transgender plus over 1% non-binary). There have also always been people who are biologically “intersex” (a recent US estimate is 1.7%): many of those seen by themselves and by others as atypical males or females, some less “binary”.

The oldest records of gender variance come from South Asia, with clear evidence for thousands of years of Hijra people, and previous traditions. Traditionally, Hijra are recognised as a third gender, and have an established position in the Hindu caste structure, roles around wedding festivities, and their own communal living spaces. Hijra combine elements of TGD and intersex. They are mainly birth-assigned male people who have a female gender identity and undergo ritual or actual ceremonies that remove external genitalia; others are people identified at birth as intersex. This highlights the limitations of applying our recent western categories to other societies historically and globally. Today India (like Germany) recognises three (not two) legal genders.

Many indigenous societies in North America, Siberia, Polynesia and elsewhere have established rituals and processes for people to adopt the social role aligned with their gender identity rather than their sex assigned at birth. In many South East Asian societies there is high social acceptance of social transition prior to or at puberty, and an absence of the later gender transition historically seen in Western societies.

Does gender transition link with biological brain differences? Certainly, historical and current attempts at “conversion therapy” for trans gender identity (as for same-sex attraction), are notoriously unsuccessful. I think the best approximate answer is that people have biological predispositions that play out differently in varied social circumstances.

Nature

Nature throws up a huge range of variation amongst humans (including neurodiversity, sexual orientation and gender identity), but many cultures have tried to squeeze that into strict binary categories — normal-autistic; normal-homosexual, normal-trans — and treat the “abnormal” as a sin, a crime, or a pathology. Within this framework we can accept the reality of the spectrum of gender identity positions — aligned with the sex assigned at birth (cis-gendered), different from it (trans-gendered) or with elements of both or being neither (non-binary).

This approach is not new — despite differing language, it is fairly similar to that developed by Magnus Hirschfeld in the early 1900s. Hirschfeld was a gay cross-dressing man, a Social Democratic Party member, doctor, and legal reformer who was a pioneer in research, medical approaches to gender transition and struggles for rights for same-sex-attracted and TGD people in Germany up to the Nazi seizure of power.

The Nazi seizure of power, World War 2, and the early Cold War pushed back transgender rights as they pushed back lesbian and gay rights. Medical understanding and possible gender-affirming medical treatments expanded, but from the 1950s onwards, TGD people were seen as having a mental illness (currently “Gender Dysphoria”), with tight gate-keeping around access to hormones and surgery by a very limited number of mental health professionals.

A few famous trans women gained some acknowledgement, such as the writer Jan Morris, but most TGD people went “stealth” after hormones and surgery — aiming to socially pass in their gender presentation. Over subsequent decades, opinion among scientists and doctors gradually became more accommodating. Sweden passed the world’s first modern “gender recognition” law in 1972. Now the dominant understanding amongst relevant clinicians and researchers has changed to seeing gender variance (including the “gender incongruence” diagnosis) not as a mental health issue, but a part of the variation in human personality structures. This is similar to reconceptualisation of autism as part of a range of neurodiversity.

Now a much wider range of health professionals (GPs in particular) engage in assessment and prescription of hormones. This de-psycho-pathologisation of gender variance in developed Western capitalist societies has followed the same trajectory as with sexual orientation, but more slowly.

However, TGD people have greatly increased incidence of co-occurring mental health issues, e.g. suicidality at around 14 times the general population. On all the evidence this is not because trans identity is caused by mental illness, but due to “minority stress”: having a stigmatised identity with consequent significant social discrimination in employment, health care, education and other social aspects, even greater than for the broader LBGTIQ community. Trans women experience both a loss of the male privileges available in a patriarchal society, and a virulent prejudice that often results in fetishisation and sexual harassment.

Seeing gender variance as a mental illness is a key point of difference for some of the left leaning “sex-based rights activists”. In the 1970s, Janice Raymond argued that growth of the “Transsexual Empire” (as she called it) was driven by medical professionals offering people individual medical solutions to social gender issues. Today Kathleen Stock argues that “woke” academia and NGOs are driving people to think they can deal with social issues by individual adoption of what Stock calls “immersive fictions”.

In recent years there have been rapidly increasing numbers of people seeking “social” transition, gender affirming hormones or surgery, across all age groups, but especially among younger people. There is much argument about why this is occurring.

Catch up

One argument, which I support, looks at the early transition patterns seen in south east Asian and other cultures. These indicate that it is likely that what is occurring here is a “catch-up” due to shifts in scientific and social attitudes in advanced capitalist societies from rejection to wide acceptance: broadly towards LGBTIQ people; and specifically of the possibility of young people transitioning socially and/or hormonally. Also, medical options are more developed and safer.

The opposing argument is that there is a “social contagion” through social media etc. I argue that the evidence for this argument is quite poor, largely relying on social media sites of parents who do not support their child’s wish to gender transition.

The arguments over gender affirming treatments for younger people are one aspect of the increasing political polarisation around TGD rights in recent years. The next article will focus on that polarisation.