Interview de Pat Califia

In your book, the transgender movement seems to have modified the doctor’s function, he appears to have become a simple technician. 

I think that you don’t have a good universal description for how that works, and there are pockets of radical change and there are pockets of resistance to that. On one end of the spectrum you have the very 1950s Christine Jorgensen approach, which is that the transsexual is this poor isolated person who’s in such terrible shape that if the doctor doesn’t give them these extreme treatments they’ll kill themselves. So the doctor is in the position of diagnosing. The surgery and the hormones are viewed as crisis interventions and the level of expectation in terms of what the doctors can do for the transsexual is really pretty low. Their attitude is : whatever we can give you, you should be grateful for. 

During the 60s when gender clinics opened in the US alongside medical colleges, they had enormous control over who was admitted to their programs and who was not, and so they really created this paradigm of dividing true transsexuals who supposedly deserved and would benefit from treatment from all the other poor sods who had gender issues who were just either too weird, too psychotic, cross-dressers, self-hating homosexuals. There were all these other categories that were very stigmatised, that were made up of people who wouldn’t make the cut into the gender clinics. And the gender clinics were very much about enforcing femininity for trans-women, masculinity for trans-men and heterosexuality. So you could not go to those clinics and say, “ I think I might be gay ”. That would be immediate grounds for cutting you out. 

When the gender clinics started to close on into the late 70s and 80s (and even in the 50s basically) then we saw the shift where at least in America, you could buy whatever you wanted. If you have enough money you can bypass all of the usual barriers and safeguards that are set up by more reputable doctors, and find someone who will give you whatever body modification you might want. 

Today what we’re seeing is this battle for control that obviously there needs to be some standards so that trans-people are not asked to spend exorbitant amounts of money in order to get surgery. As a therapist I think their is still some value in helping people who have gender issues figure out whether permanently changing their bodies is really going to work for them as a lifetime strategy. It doesn’t work for everybody necessarily ; it’s not what everyone needs to do with their gender questions. There are good and bad things about paying out of pocket for your hormone treatments and for your surgery. The good thing about it is that, if transsexuals have the power of the consumer under capitalism they can go where they want, and escape the control of medical institutions. On the other hand that does not mean the quality of care is necessarily higher and sometimes it means it’s worse because at least in the gender centres that were run by the medical universities there was a little bit of control in place about the quality of the medical care.

But in countries like France where there’s state subsidised health-care, what that means for transsexuals is that we sometimes spend decades in psychiatric treatment ; we may be sent on these wild-goose chases by doctors who basically feel that transsexuals are psychotic and so there is no reason to co-operate with the patients’ psychosis by giving them these ridiculous things like hormones because of course she can never change her gender. And the quality of care under state subsidised health systems is not necessarily that great and of course the state winds up being in control of it. I understand that in France it is actually illegal for people to pay a doctor independently for their surgery but a lot of people wind up going out of the country looking for the best doctors. It is great in a way that trans people are saying, “ It is up to us to decide whether we want any medical intervention at all, whether we want all of the things that you can do, or we only want part of it, like chest surgery but not genital surgery or maybe hormones and no surgery at all “, but the stigma in the medical profession, and the psychiatric profession, prevent a lot of doctors from entering those fields interacting with transsexual people and so we still have a real problem with the quality of the surgery. It is sad that often people feel like they have to chose between keeping their ability to function sexually and going and getting genital sex reassignment, which may be poor cosmetically and may not allow them sexual functioning. It still is a work in progress. It definitely tweaks doctors not only to see transsexual people not as isolated patients but as members of a community that they are held accountable to, but also to see more and more trans people enter these professions. So now you have transsexual and transgendered people who go to the Harry Benjamin meetings, they are getting certified as therapists and as doctors, it makes those mainstream practitioners more and more uncomfortable.

Are there any barriers to prevent transgendered people from entering the medical field ?

There are lots of them. I was told when I began my training as a therapist that I would never get a license. There is a morality clause in the California licensing requirements, so that if the Board really wanted to they could probably yank your license and say you are not the kind of person who should represent our profession. That did not happen to me, but I really had to persist, because through that whole process there is enormous discrimination and it is really hard to sit through a training program that basically tells you that people like you are really sick and messed up. I had to do a lot of arguing, a lot of resisting, a lot of trying to get my classmates more accurate information. It is really an unpleasant process, it is very unpleasant to sit through. 

Aren’t these barriers set up because if transgendered people know the “ truth “ about their gender then the doctor is invested with less power ?

Absolutely. And the same is true for the therapist. There are people who are drawn to these professions because they want to insulate themselves behind a barrier that turns them into an authority that cannot be questioned. And so with people who have that kind of personality there is especially high resistance to meeting transgendered people on more equal terms, giving them value as human beings, respecting their desire. There is enormous resistance.

Is investing the medical field the only way for transgendered people to avoid this problem ? Aren’t there any other ways to fight this resistance than becoming part of them ?

There are other ways. I wouldn’t want to wait until we could receive services only from other transgendered people. The whole point is to educate people who aren’t transgendered so that they can treat us decently. I think the first step is just that we talk to each other. The old model for “ treatment ” was that you take your hormones, you get surgery, you totally pass, then you burn everything from your childhood change your name, change your ID, move to a different city and start over again, and you forget. You blend in. More and more people are saying “ No , that does not work I still have a unique body, and medical problems I need to talk about, my partner needs to know about my status “. We talk to each other and share our experience about who we saw, how they behaved, what we want and we advocate for each other. I all the time take transmen in San Francisco to doctors’ appointments, share information with them, take them back home after surgery. It really makes a difference that the doctors know that they are not just going to see one person who won’t ever talk to anybody else. We share information. Community is really the best way to bring about that change. 

It appears that doctors still hang on to their role of guardians of heteronormativity. 

But to be fare we should acknowledge that just the fact that someone has gender dysphoria does not mean that they are a feminist or that they are aware of queer politics and I think there are still many people who think of themselves as transsexuals who just want the right to live ordinary lives. I understand that temptation because I am at a point in my life where if I don’t tell somebody I am transsexual they don’t know. I can pass in most situations. It is hard to remain out of the closet because what that means is that people are always questioning your identity, and that’s uncomfortable. For them but also for me. I don’t enjoy it when I can feel the change. A good example is if I go to a gay bar and sitting down with other guys I’m looking at somebody who is attractive maybe he is attracted to me and if a friend of his takes him aside and says “ That FTM, I’ve seen him talking “ the whole atmosphere totally changes. I don’t enjoy that, it means that there is no sucking. 

In what way did the transgender movement undermine the concept on which the essentialist movement based its fight ?

Homosexuality is based on a kind of gender essentialism. It is based on the idea that men and women are different and those differences are inherent and really important. So there is enormous resistance on the part of lesbians and gay men towards accepting transgendered people and validating our identities whether we see ourselves as men, as women, as third gender people, intersexed… I think it can be every bit as hard for someone who is a lesbian feminist to deal with a trans woman who is also a lesbian feminist, as it could be for my Mormon mother to deal with the fact that I would want her to use male pronouns if she were still alive. And for a lot of the same reasons. The happy queer LGBT community is not really all that happy. And when it comes to feminism, there have always been many different feminisms, and probably the most popular brand has a pretty simplistic ideology about gender. What that ideology says really is that patriarchy is that evil thing that men have done to women, and if women rise up and defeat the men then everything will be OK, and it is never clear exactly how far that needs to go. In lesbian separatist visions of utopia there just are not any men anymore. The truth is that that would not eliminate hierarchy, class privilege or racism. Foucault was right when he talked about the fact that power is not this binary quality where somebody has it and somebody does not. Feminism has never really examined the role that women play in maintaining the gender system. And even though women have less power in that system than men do, women’s contribution to it is still very important. If your belief is that women are by virtue of their biology and their role in society more suited to liberate the world from sexism than men are, then obviously it is going to be hard for you to deal with people who are genetically male who identify as female or vice-versa. That will change very slowly. I was sitting with a group of dykes from Bordeaux at diner last night. One of them said to me, “ Well we’ve talked this over and we think we could deal with having a relationship with a FtM but none of us would want to have sex with an MtF. “ And I thought “ So rather than give up your gender essentialism you would rather have sex with somebody with a beard who refers to his genitals as a dick, than have sex with someone who has tits and wants to be a girl. “
That to me personifies how deep it goes. These were not transphobic women, they came to the presentation, they were very open but their talking about how their eroticism functions, I know that some of that is involuntary. It’s a difficult question. Is a gay man being transphobic if I don’t give him a hard on. Maybe yes, maybe no. Some of that is not under his control, whatever his politics may be. 

How did the feminist movement respond to these transformations ?

The majority of the feminist movement has really been horrible to transsexuals and transgendered people even though the reproductive rights movement offers a very clear parallel : if women have a right to control their own bodies, even to the extent that they have the right to abort a fœtus then surely people have a right to change their bodies in terms of their secondary sex characteristics. But the women’s movement has never really seen it that way, and it was not until the AIDS activist movement and more of a concept of queer community developed that there was a brand of sex positive feminism that was a little bit more flexible a little bit more ready to hear about transgender rights. It is important to notice that there is that strand in feminism that never is the folks that the media go to talk to when they want to do a story about say pornography. 

Radical feminists react in the same way to leather dykes. What do leather dykes and transgendered people have in common that the radical feminists cannot accept? ? Why did they move closer to reactionary movements rather than to transgendered or SM people ?

There are really a lot of reasons why that has been true. Just to hit the high-points, SM and transsexuality have been identified with patriarchy. SM is seen as an eroticised form of violence and perceived as the opposite of egalitarian sex and there is no room to really take in information about safety of consent. With transsexuals, Janice Raymond’s position is that we are the creation of the patriarchy, that doctors create MtF people to infiltrate and destroy the women’s movement and the process of moving from FtM is this escape route to acquire male privilege. Which is really stupid because a lot of FtMs never identify as lesbian. I have a history in the lesbian community but I know other FtMs who were straight before they came out and their husbands had to deal with the fact that they were married to men. All of these positions are taken partly out of the desire to protect the good name of lesbian feminism from sexual perversion and these steps are taken by people who have never really wanted to deal with lesbian sexuality in all of its diversity. They have tried to package lesbianism as this ultimate form of feminism that only has to do with oppression of women and does not have to do really with lesbian desire. 

Does this rejection from the lesbian of feminist activist movements prevent the formation of a transgender community ?

Let’s not leave out the whole gay community. During the 1950s and a lot of the 60s there were a lot of gay people who understood their homosexuality as a gender deviation and the “ true “ homosexuals were either sissy guys or butch women, fem lesbians were not really seen as being homosexual, they were actually straight women who were attracted to butch dykes because they were masculine like men and vice-versa. One of the things that gay liberation did was wipe out that whole paradigm and replace it with urban gay male machismo and this really tidied out lesbian feminism that did not have anything to do with dirty sex. Until that point in time there had not been that much of a distinction between prostitutes, gay people and transgendered people. We were all in the same bars, and it was after that point that it steadily got to be more and more difficult for all of us to feel like we had anything in common. With the transgendered community, places where we should have been able to go for role-modelling, for support, were rejecting us very vigorously. We wasted a lot of our energy probably trying to find a place with people where we were not welcome. Once again here is another sexual minority reinventing the wheel. Every community has to do it, the gay men’s community, the lesbian community, bisexual people, SM people, transgendered people. As an activist who has been involved in all of those movements I just think it is incredibly tedious that people cannot see that there is this larger system of sexual repression that ties us all together.

How do you think the links can now be made between all these communities ? Is the queer an answer ?  Is there an answer ?

I think there is an answer but I think it is not just an intellectual challenge, it is an emotional and psychological challenge, because there is so much shame in our society about gender variation and sexual difference that it is all most people can do to confront the specific ideology that represses their particular identity, and particular community. If you take a little step back and see how it works for everybody, what you can see is that we are still dominated by Christian values about sex, that the only thing that is good about sex is reproduction, that men and women have to polarised, there has to be this gender binary and that the only good kind of sex is heterosexual reproductive sex. And just as it is obvious to me that the links are there if people are brave enough to look for them, but one of the main obstacles is shame, and the fear of “ if I affiliate myself with these other people, then I might not get advancement in my civil rights and other people will think I am just like they are “. I see shame as being a major psychological issue but also as a political obstacle. 

Not only shame from the outside but also shame from people within your own community.

A good example of that is an opinion that I heard expressed. There was a meeting called to deal with some trans issues, but it was called by a straight organisations and facilitated by people who are not trans. And when that question was asked about that, one of the trans people said “ No we have to have them here because if we do not we will all fight with each other ". In addition to behaving more like adults and being more courageous we have to win each others trust and deserve each others trust and not discriminate against each other. And shame does that. It is very corrosive and shame divides us from each other in a very dramatic way. 

How do you account for the difference between the feminist essentialist reaction (very violent) and the gay community’s reaction (tried to recuperate) when faced with the transgender movement ?

There has not been that much difference. The lesbian community tried to claim what they call passing women as heroes in lesbian history when it would be very possible instead to view those people as FtMs and some gay male historians have labelled people who I think of as trans women as gay antecedents, like the berdache. Who do the berdache belong to, do they belong to faggots or do they belong to the trans people. When we are dealing with non-western cultures, the labels that we are used to probably do not apply and we need to be very cautious about categorising them with our own categories. Getting that T added to LGBT is still not accepted in a lot of quarters, and I think gay men have been pretty snotty about trans people and most of the organisations who call themselves LGBT have very few trans people if any on staff and do not offer good services to our community. At this point I feel very sceptical and ripped off about it. 

There are some LGBT organisations that use that T to get more funding. Especially with the HIV epidemic, as epidemiologists reveal the enormous raids of infection amongst trans women who are sex workers there has been funding to do HIV prevention for trans people but often those funds are completely misused. There is a good reason for trans people to be very angry with the gay community. There has been some progress but we are not anywhere near being done with it. It is hard to because a lot of transgendered people do not identify as gay. Take the example of an AIDS service organisation that was created by gay men when the epidemic began. They have now seen the profile of the disease totally change, so they are being asked to provide services for communities of colour and for people who are injection drug users, they have hated doing that, they have resisted it as much as they can. Now we have trans people added to that. How does it work for a gay male outreach worker on the street to go talk to a trans woman who is hooking to make money for her hormones and her surgery, to her it is very important to say “ I am not a gay man, I am a woman “. How is she going to be able to talk to this guy, and how is he going to be able to talk to her. She needs to see somebody on the street who reflects her experience, and that is something that we see with a lot of agencies that deal with queer youth. A lot of queer youth label themselves as gender queer, they do not identify at all with the term gay or lesbian and they do not want to get services from those organisations because they feel like they are being pressured to make these decisions that have nothing to do with the way they perceive their own lives. 

Earlier on you talked about the idea of a third gender. Could we come back to it ? 

In Polynesia there is a social role available for people who are born male who want to live in female attire. As those societies encounter western technology, what they found was that amongst that group of people, some of them began to identify as gay, some of them identify as cross-dressers, and some of them start to say : “ Oh no, I’m transsexual “ and start to take hormones. It is interesting to me that there is no single western category, that fits people who have adopted that traditional social role. And I think you can say the same thing with the hijrah of India. Some would say “ I am a woman “, some would say “ No, I am something else “. And amongst trans people themselves, I think that right now there is a significant number of folks who say “ I want to live as much as I can without gender. I do not want to be defined as a man or a woman. I am a trans person. “ Leslie Feinberg is a really good example of someone who has taken that path. I think it is really difficult to live that way because those male and female boxes are everywhere. I think it is very important to know that that is an option, and to make it easier for people to pursue that path, especially because genetically, not everybody is born with XX or XY chromosomes. Inter-sexed people do occur in one every 2000 births. Even nature is telling us basically “ Don’t just think in terms of male and female “.

How do you account for the fact that gay intellectuals hardly talk about FtMs ? 

Gay male academics have not really caught up with FtMs yet and most of the good scholarship about gay and bisexual FtMs has been done by us. Jacob Hayle’s papers and Jason Cromwell’s book for instance. In gay history and anthropology, there continues to be a very fierce debate about third gendered people in traditional societies and whether we should call them basically gay men or transsexuals. I think gay men feel very threatened by the idea of men with vaginas. For gay men they often come out with a sense of injured masculinity. On the other hand there are also gay men who have been really wonderful about FtMs, who have been very secure, very welcoming, so I would not want to trash the whole gay male community, I want to recognise that we do have some really wonderful allies, and I think it will be a slow process for them getting used to the idea. 

Word is out in San Francisco that there are gay FtMs, and some of the gay men there have got very paranoid about it : ” Oh my god if I go to a sex club and I stick my dick in a gloryhole, how will I know who is on the other side. “ There is a club called Blow Buddies that is a really sleazy joint, and they have started doing a dick check at the door, and in order to get into the club you have got to get your dick out. I’m talking to all the other queer FtMs I know : “ Well let’s go do it. Let’s go drop our pants and say here it is. “ I want to see what they will do. And if they will not let us in, let us call the Human Rights Commission and file a grievance. 

How active is the transgender community nowadays ? Is it hard activism ?

There are so many kinds of politics going on right now. There are people who do mainstream lobbying, trying to get new laws passed. Some people go scream at the American Psychiatric Association, and do more outrageous street stuff. And there are lot of people who are trans who are just really struggling to survive. What is amazing is that any of us have enough energy let over to do anything political. 

In the United States, activism has just got its ass kicked by 09/11, we have all of these new laws that are really scary because with the US Patriot Act they can do surveillance without a search warrant they can lock you up and not tell anybody they have arrested you. Your defence attorney will not be allowed to question all the witnesses against you, or even see all the evidence against you. There are secret courts. And the penalties for engaging in any kind of political activism have escalated sharply. It used to be that if you got arrested breaking a window on the street maybe you would get charged with a misdemeanour, but now it is clearly going to be a felony and you will do jail-time. People are scared. And it has also become less popular to speak out against anything that you do not like that the government is doing because we are all supposed to be these great patriots, supporting this absolute bullshit thing we are doing in Iraq. What has happened to the trans movement in the US is in that context of a huge move to the right that has taken everybody’s breath away. It was really shocking to have Bush win the office of the presidency in an election that was clearly illegal. If that can happen, if an election for a president can be stolen then what hope is there to make anything be fare or just. A lot of people right now are very discouraged and frightened.

During the 60s and the 70s, the transgender movement was structured like the Civil Rights Movement. In the 90s it seems to have become more radical. How do you account for this change ?

We have to give some of the credit to very talented people who came along such as Ricky Wilchons, and some other people I mention in my book. As individuals they did a lot to kick everything into those high-gears Kate Bornstein. Some of it was the pro-pleasure feminism which became a lot stronger and that created a safer place in an alternative culture to talk about gender as an aspect of sexuality. As the community gets bigger it will support more sophisticated undertakings. Some of it is just probably the will of fortune. 

Kate Bornstein mentions a possible link between queer activism and class struggles. Can queer activism bring tools to the class struggle ?

I think it should. But trying to get Americans to think about class is like trying to make french people think about queer. There is this real carrot and the stick in capitalism and the carrot is this idea that if you are really smart and you work really hard then you to can be Bill Gates or Donald Trump, so nobody exactly wants to give up their shot at that much embarrassing excess of wealth. But at the same time it is really clear that most of us will barely survive and are going to have to do jobs that we really hate. I find it very difficult to get gay people in America to think about class and I find it difficult to think about myself because I am not really sure what the alternative is. And it raises a question of priorities, there is so much wrong with the world right now, what do we focus our energies on ? Do we think about industrial pollution and destruction of the environment, do we think about world wide poverty, do we think about AIDS and other health issues. That is another thing about being an activist that is hard right now, there are so many connections that can be made about the way that there is a system of first world privilege that is held in place. But to go back to class in the gay movement you see a real difference between gay people who are either middle class or who aspire to be middle class who are assimilationist. The more people are invested in the class system the less they really want to question gender norms or the norms for sexual conduct, the more they tend to phrase their arguments in terms of we just want to be like everybody else. I really don’t want to be like everybody else. I think it is a nightmare.