The trial over Arkansas’ ban on gender-affirming care for trans children recently began. As vulnerable children await to hear if their bodily autonomy will be stripped away, we should remember that cisgender children seek gender-affirming care with relatively little social stigma attached.
Twenty years ago, in rural Maine, I was one of them.
As a teen boy who identified as a boy — randomly sprouting breasts really, really sucked. I hated my body, wore a shirt in the pool, dreaded the school locker room, dressed in layers and walked hunched over to hide my shape.
When I was going through puberty, my body’s hormones were firing in every direction, and I started developing breast tissue similar to a girl’s. The technical term for this condition is gynecomastia, but most of us know it as the dreaded “man-boobs.” Up to 60% of teen boys have asymptomatic gynecomastia, according to the National Institutes of Health. Adolescent symptomatic cases, like mine, are less prevalent, but it affects about 65% of adult men.
As a teen boy who identified as a boy — randomly sprouting breasts really, really sucked. I hated my body, wore a shirt in the pool, dreaded the school locker room, dressed in layers and walked hunched over to hide my shape. I lived in constant fear of nipple-grabbers at school (teen boys are weird) and being outed as a “boob-haver.” I was uncomfortable and embarrassed 24/7 and had about zero percent confidence in myself, all because of the misalignment between how I felt I should look and how I actually looked.
When I confided in my conservative dad about what was happening, I was about 15. He saw how much this was holding me back, and we immediately went to a plastic surgeon for a consultation. A quick procedure and a few weeks of wearing an ace bandage later, I was flat-chested and finally had a body that looked like mine.
Trans children deserve the same consideration.
The next year was the best year of my life up to that point. I felt great. I felt confident. I made a ton of new friends, decided to get in shape, played a sport, put gel in my hair, started dating, partied — all the good stuff. For the first time, I felt and acted like an average teen instead of just barely participating out of aggressive discomfort and fear. I went from a guy who hated being seen to the most seen guy at school in no time.
Over the years, I’ve had medical procedures that saved my body, but my breast reduction saved my mind. Receiving care that affirmed my perceptions of my gender drastically changed my life for the better. I can attest that having mind-body alignment feels like a superpower.
The care that I received is just one small example of the gender-affirming care that cisgender folks receive regularly. We just call it “health care.” I got breast-tissue reduction surgery, but breast augmentation for cisgender women to conform to a perception of womanhood is even more common. Cisgender people alter their eyes, noses, lips, faces, hairlines, facial hair, body hair, height and even the nether regions to more closely align with our culture’s ideals of “the perfect man” or “the perfect woman.”
We frequently change or “enhance” our bodies hormonally, too. Kids have been dosed with human growth hormone since the ‘60s to make them taller, and men looking to achieve a cartoonish level of “manliness” get testosterone pumped into their veins. Hormone replacement therapy is commonplace for cis-women and men looking to maintain or enhance their vitality in ways that align with their gender identities and gender ideals.
The care that I received is just one small example of the gender-affirming care that cisgender folks receive regularly. We just call it “health care.”
But I don’t see the care that affirms cisgender norms, expectations and functions, including for children, being questioned to the same extent as transgender care. By contrast, even the most basic of trans care — respecting gender identity and expression, puberty blockers and hormone therapy — is scrutinized endlessly and demonized to the point of being life-threatening for patients and doctors alike.
The double standard is glaring. And a recent viral interview between Jon Stewart and Arkansas Attorney General Leslie Rutledge about her state’s ban on gender-affirming care for trans youth points to a large part of the problem. Without being able to name a credible source, Rutledge claimed that 98% of youth with gender dysphoria would grow out of it. To which Stewart replied, “Wow, that’s an incredibly made-up figure.”
This idea of elected officials stripping away the autonomy of parents and children to make the kinds of medical decisions that would be best for them is appalling. As Stewart pointed out to Rutledge, the state is not even allowing parents to weigh their options based on the guidelines of the country’s top medical organizations.
We should think more deeply and compassionately about those seeking health care in the trans community as they suffer mind-body misalignment that many of us can’t even imagine. Having a little empathy is a good thing, and for those of us who get to bathe in the privilege of doing whatever the hell we want to our bodies, it’s probably even our responsibility.
Some folks may disagree that the care I received was gender-affirming, and I’ll admit I’m not an expert on health care — cis, trans or otherwise — but I am an expert on me, what I did and why I did it. For me, it was straightforward: I’m a dude, I was born a dude, I want to be a dude, and having breasts didn’t align with that for me. They needed to go for me to live a fuller life.
Some may also argue that societal pressures and expectations influenced my choices, and to that, I don’t necessarily disagree. Who knows, if breasts on a guy were the pinnacle of manliness in 2002, I might have rocked it, but surgery is a lot faster than turning the Titanic of culture, and I would have missed some of the best years of my life waiting.
Here’s what I know for sure, had I been trans and seeking the same surgery, there’s a good chance it wouldn’t have been as easy as it was for me — 20 years ago in rural Maine or today.