“It was like I had to fit into a category”: Care-seekers’ experiences of gender regulation in the Swedish trans-specific healthcare

Abstract

The few previous studies investigating regulation of gender in trans-specific healthcare are mainly based on text material and interviews with care-providers or consist solely of theoretical analyses. There is a lack of studies analysing how the regulation of gender is expressed in the care-seeker's own experiences, especially in a Nordic context. The aim of this study is to analyse narratives of individuals with trans experiences (sometimes called transgender people) to examine how gender performances can be regulated in trans-specific care in Sweden. The conceptual framework is inspired by trans studies, a Foucauldian analysis of power, queer phenomenology and the concept of cisnormativity. Fourteen interviews with people with trans experiences are analysed with constructivist grounded theory. The participants' experiences indicate that gender is constructed as norm-conforming, binary and stable in trans-specific healthcare. This gendered position is resisted, negotiated and embraced by the care-seekers. Norms and discourses both inside and outside trans-specific care contribute to the regulation and limit the room for action for care-users. We conclude that a trans-specific care that has a confirming approach to its care-users, instead of the current focus on gender norm conformity, has the potential to increase the self-determination of gender performance and increase the quality of care.

Mind, Body and Boundaries: Self-Presentation on the Nordic LGBTQ Online Dating Scene

“…The un/alignment that constitutes cis-gender and transgender as discrete identities is based on a structure that installs sex/biology as having defining priority over gender/identity, where sex and gender is fixated in relation to the male/female binary (Detournay, 2019). This is seen in the Swedish trans-specific healthcare, where gender is still at large constructed as norm-conforming and binary (Linander et al, 2019) and in Swedish newspaper, where articles meant to empower trans people reinforce heteronormativity through constant referral to binary gender (Åkerlund, 2019). Similar to the United States, where the transgender movement successfully has changed United States public policy over the past two and a half decades (Nordmarken, 2019), acknowledgment, theory formation and discussions about trans and non-binary issues have increased in the Nordic countries (Haavind and Magnusson, 2005;Magnusson, 2011).…”

Trans youth in Portugal: gendered embodiments

“…The study's findings contradict those of Garrison (2018), who claims that trans people who conform with the ideal of the wrong body model are more likely to challenge dominant gender normativities and break gender stereotypes than those who identify as nonbinary. However, the accounts of the participants in this study suggest that there is limited room for action for trans youth who do not intend to adhere to cis heteronormativities (Linander et al 2017b), particularly those who do not present a fixed and stable gender identity. Indeed, in this study only a minority of trans youth were able to express themselves in a more non-binary, gender-diverse wayperhaps due to 'structural limitations' hindering the possibility of everyday lived experiences beyond the binary (Moon 2019, 58).…”

“…This is an important finding as it confirms Linander et al's (2017b) argument that individuals who identify as non-binary may also be interested in gender-affirming medical procedures. To effectively address the needs of trans individuals, it is important to replace the current emphasis on gender conformity in trans-specific healthcare with a more affirming/conforming approach (Linander et al 2017b).…”

(Re) Making gender in the clinical context: a look at how ideologies shape the medical construction of gender dysphoria in Portugal

“…Without biological evidence to support decisions on GD, and as the diagnostic attribution is based upon the "distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender" (APA 2013, p. 451), practitioners tend to deal with the uncertainty that characterizes the diagnosis of GD by employing gatekeeping practices that are understood by them as a tool to prevent regret regarding permanent bodily interventions such as genital surgery and infertility due to hormone therapy (Shuster 2016). Thus, there is a danger that practitioners base their decisions on the attribution of GD on their own assumptions regarding the nature of gender (Whitehead et al 2012) which might not allow room for the gender self-definition of trans people (Linander et al 2017b). Research into the diagnosis of GD and its attribution that has privileged the standpoint of practitioners concerning this matter is scarce, particularly in non-English speaking countries (Richard et al 2014).…”