“That’s the sick trans person”: Negotiations, healthcare, and the tension of demedicalization

Abstract

This dissertation addresses two key issues: the barriers between trans people and quality healthcare and the ways in which trans people overcome those barriers. Based on research that included interviews with trans people in the U.K. and autoethnography, this thesis articulates a fundamental tension between a) making an argument for demedicalization based on the harms of the current medicalized model, and b) the fact that some trans people are reliant on medical technologies. Within the course of examining this tension the dissertation contributes to the disciplines of trans studies by: highlighting barriers to quality healthcare so that they may begin to be removed; uplifting trans voices and experiences as rich sources of knowledge; better understanding gender and how it operates socially, and imagining new possibilities for trans models of health and healthcare. Additionally, this work outlines and demonstrates a model for a trans methodology. In laying the groundwork for the dissertation’s argument I come to an understanding of sex and gender as two related but equally socially constructed and ultimately selfdetermined characteristics. In addressing the first issue I identify how transness has been medicalized along with the benefits of demedicalization and look at how bureaucracy, time, and space factor into trans health. In addressing the second issue, I focus on the specific knowledges trans people accumulate in order to navigate accessing healthcare (what I call TransLiteracy) and the social and decentralized model of pedagogy used to teach and learn these knowledges. The dissertation concludes with an articulation of an imagined healthcare system which presumes a trans subject and a way of accessing medical technologies without medicalizing transness. Thus new perspectives on transness, medicalization, and research methodologies are offered as additions to the growing body of work on trans health in the U.K. and globally.