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Over the many years of my work with patients and clinicians about transgender, ‘trans’ has moved from referring to a little known phenomenon affecting a very small number of people (largely transsexuals who underwent gender transition via medical treatment) to include anyone who is gender non-conforming. In the process transgender has become central to the idea of identity politics, social justice theory, and an issue capable of splitting a political party. For forty years in the UK a few clinics, public and private, operated with a clientele the majority of whom were men in middle age who wished to transition medically to live as women. In 2004 the Gender Recognition Act gave people who had transitioned socially the right to change their birth certificates, and the Equality Act 2010 made discrimination against them illegal.
To understand how this little known minority group went from relative obscurity to becoming, by 2017, a major and controversial subject within the media and politics is beyond the remit of this review. However, to appreciate the relevance of this book and to understand the extremely hostile reactions to it from some quarters, it is necessary to place it in the context of ‘trans’ becoming a focal subject for the media and politics. In addition, over the last few years the clinical profile of people presenting at gender clinics has undergone a significant change, becoming much younger, and greater numbers of young women; as well as many new gender identities emerging, such as ‘genderqueer’ and ‘non-binary’. ‘Trans’ as a social and political movement had arrived. Transgenderism and transsexualism are in fact under-researched fields where two camps - one favouring theories of gender as innate and neuro-biological, the other psychological and/or social-constructionist - have offered various theories as to why someone would seek gender reassignment. However, most research predates mass use of the internet and is inconclusive.
This book provides a critic