Anisotropy

Last week the World Professional Association for Transgender Health published an 8th version of their standards of care for trans and gender diverse people. It’s been interesting and encouraging to see the trends in the guidelines relative to past standards of care. The new guidelines recommend streamlining how trans people get access to transition-related healthcare. Wait times between the start of hormone therapy and surgery and requirements for gatekeeping letters of recommendation are reduced. Informed consent as a model for HRT in adults is endorsed.

It’s not an exaggeration to say that the last SoC update, released in 2012, saved my life. Directly, this update led to HRT becoming much more widely available without the stigmatizing gatekeeping of the past. More broadly, this was part of a shift in the culture that led to trans healthcare becoming more accessible over the 2010s, and trans people becoming more visible. It was only in the last decade that it became clear to me that trans people aren’t rare birds, we’re everywhere. I doubt I would’ve been able to take the leap to start transitioning without either of these effects happening. That leap was necessary to have the life I have now.

So I’m glad to see the needle continuing to move this way. Lord willing, those who come after us will suffer less and find the peace and joy of self-discovery earlier in life and with less heartache than those who came before. At least in this one narrow aspect of life. We’re living in a time where things happen to be changing very rapidly in this space, and they’re changing in the best possible way, medically at least.

I’m not the first trans person in my lineage. People like me have always existed, in all times and all places in human history. But I was the first one in my entire family tree to come along after the type of transition I’m making became possible. It’s a dizzying place to be. In the past, it was impossible. In the future, it will be much, much easier for my descendants to walk this path. And then there’s me, right at the moment of phase change.

The principle of anisotropy, that things are the same in every direction, is a recurring theme in astrophysics. It’s assumed that the location of Earth in time and space isn’t special, because generally speaking things look about the same every way you look. The thought that there is no center to the universe passes the vibe check better than the notion that the Milky way is located right at the heart. Likewise, the assumption that other stars tend to have planetary systems a bit like the Sun’s has been validated so far by exoplanet searches. Time is just another variable, like space. It’s usually reasonable to assume that the past and the future should be about the same.

But that isn’t the case here. The past is one way, a foreign land I’d rather not visit. The future is fragile, the work can be undone at any time, but it looks to be a much friendlier and more welcoming place. It seems strange that, in my otherwise ordinary life, I’ve been placed right at the fulcrum where this lever pivots. It’s a privilege that I don’t quite know what to do with.

I’m trying to do my best anyway. I hope my story doesn’t completely vibe with my descendants, because I hope they never have to deal with the wilderness of denial and cisnormativity I faced. But I’ll do my best to help them understand what it was like here, where the isotropy was broken.