I can't quote
@Piss Bear but about that affirmative therapy thing. This is a perspective I can't shake about trans health care.
I was inpatient on and off and consistently in treatment for an ED for most of a decade around my teens. EDs are disorders that come with heavy, heavy body dysphoria. Many of us were able to vomit purely by thinking hard enough about how disgusting and fat our bodies were. Many of us had experienced sexual abuse and found our post-pubescent bodies psychologically unendurable, or believed they were to blame for what had been done to us. I read what the youngsters say about their "gender dysphoria" and I i understand the feeling, if not the gender fixation.
But. The one thing that absolutely no one, not a single person, involved in our care was ever prepared to do was in any way affirm or validate the disordered thoughts about our selves and our bodies that made up our illness. No one ever told us that our visible bones were "beautiful", or the girls getting a total dental clearance due to acid damage were getting "ED affirming healthcare". There were no mirrors anywhere. There were deliberately heavy, shapeless clothes. There was no access to media that we could have used as inspiration or helped us to start spiralling about our body image. When they weighed us, they made damn sure we couldn't see the numbers on the scale: that was something we were absolutely not allowed to know.
When we flat refused to eat, when one of us decided to starve until death, our parents consented to an NG tube. It was disgusting, it was invasive beyond belief and for many of us it was incredibly triggering. (Not tumblr triggering. Actual, raging PTSD triggering. We weren't coming in and out of inpatient because we were playing with a full deck at the time.)
And it was done because the job of those caring for us - tirelessly, beyond the call of duty, in the face of our rage and noncompliance and frankly, sometimes outright abuse - was to keep us safe and alive until we got better. It was always, always reinforced to us that we were sick. That the thoughts we had about our bodies were an illness. They weren't real. The job of those caring for us was to help us escape from those thoughts ruling our lives. There was endless therapy. Sometimes, pills. More therapy. Tireless, endless attempts to get us to vomit up what the actual triggers for our illness were.
Group therapy was stopped, many times, because our collective will was much stronger than our will alone. We lifted each other up, reinforced each other's determination not to eat, bodychecked each other endlessly, shared each other's triumphs in resisting eating and in resisting getting better. I often think about that when I come across "online trans communities". It was so much harder to give in and give up when there were others holding on to you, and relying on you to hold onto them. We didn't seem so ill when we were all together affirming our illness in group. We seemed like we were the ones who were right, and the rest of the world just disgusting fat blob bleeder scum who envied our beauty and our discipline. They couldn't do what we could do, so they were trying to make us fail.
Some of us died. But many, most of us, got better. Not completely better, I don't think anyone ever gets completely better. But well enough to live normal lives in society, to have the tools to work continually at having a healthy relationship with food and our bodies, and to not make the same mistakes with our own families as were made with us. Our care teams never gave up on us, no matter what total screaming assholes we were being at the time. They never gave up on our future.
If just one of our caregivers had affirmed our delusions, if just one of them had said, "Yes, you've gained weight", or worse, that we were beautiful or strong or warriors or stunning or brave, we wouldn't have got better. If they had, in the cause of human rights, let us refuse all our treatment, get liposuction and jaw wiring, and prescribed us laxatives and appetite suppressants, to affirm our "identities" as little girls trying to starve themselves into invisibility and nothingness,
they would have killed us.
I look at trans affirming health care for children and young people, and I do not understand why that is different. I do not understand why trans-affirming caregivers choose to support and accelerate this self harming, delusional behaviour instead of placing themselves between their vulnerable patients and the drive to self destruction.
I was protected from myself. I fundamentally cannot understand why other little girls now are not protected from themselves.
passing
