The 2021 census (excluding Scotland) showed that 262,000 (0.5%) of the population declared their gender identity different to their birth gender. The EU Agency for Fundamental Rights estimates that at least one out of every fifteen people in Europe has a gender identity that differs from that assigned at birth. Despite these small numbers, the transgender landscape continues to change rapidly, coupled with trans activist groups (LGBT+ Foundation and Stonewall) campaigning widely to seek societal changes in gender ideology and thinking. Even definitions of gender have witnessed changes in modern times. The updated Cambridge Dictionary defines a man as an adult who lives and identifies as male though they may have been said to have a different sex at birth.
The media often focuses on the rights and lifestyles of trans women and non-binary people, leaving trans men in the shadows despite their similar plight in needing to escape the torture of previously living in a gender wrongly assigned to them at birth. There is rarely a mention of how trans men respond to entering the world of manhood, where misogynist behaviour and patriarchal trends dominate. Perhaps the image and perceptions of cisgender men (non-trans) could benefit and change by welcoming trans men, who bring a more refined version of masculinity to manhood. I wonder what Aristotle would have thought about trans men, given that he once said women were inferior deformed versions of men. But the worst discrimination comes from within the LGBT+ community, where it is claimed that irrespective of how handsome a trans man is, he will still face outright rejection from cisgender gay men because he is unlikely to have a penis.
Interestingly, there is sometimes media debate about the safety and privacy of cisgender women sharing single-sex toilets or same sex-wards in hospitals with trans women. How cisgender men feel if trans men share gender-specific spaces with them, however, is rarely considered. Likewise, there does not seem to be the same level of debate about trans men (who haven’t undergone gender-affirming surgery) being sent to male prisons.
Trans activists are campaigning for words like ‘bonus hole’ or ‘front hole’ instead of vagina to prevent causing offence or trauma to trans women (and some non-binary people) who have not had genital-affirming surgery. Yet activists appear less interested in how the word ‘penis’ might be negatively restimulating for trans men (and some non-binary transmasculine people), bearing in mind only a tiny percentage undergo genital-affirming surgery. Over the past five years, there has been a huge rise in trans operations, particularly double mastectomies and hysterectomies for people in their early twenties.
Some trans men who have not had their uterus and ovaries removed get pregnant, resulting in the NHS using inclusive language like ‘people who are pregnant’ and ‘birthing parents’ to avoid using words like ‘mother’ and ‘new mum’ which might offend some people. There is also a push among trans activists for ‘chest-feeding’ to be used instead of breast-feeding because the latter may induce dysphoria or discomfort for trans patients. The irony is you could count on one hand the number of transmen giving birth in the UK each year.
Trans men tend to be the quietest group within the trans community. Many pass easily as men after being on testosterone and undergoing top surgery, resulting in high numbers going ‘stealth’ (concealment of trans identity). Nevertheless, trans men face enormous challenges in their physical and emotional wellbeing. It is estimated that up to 75% of trans men suffer domestic abuse from male perpetrators, including high levels of verbal and emotional abuse. A large percentage of trans men have mental health problems, including depression, suicide attempts, mental health-related hospital presentations and non-suicidal self-injuries. A significant number die by suicide.
Figures obtained before the closure of Tavistock Clinic in early 2023 (due to be replaced by two regional Gender Identity Development Service hubs in 2024) revealed that of the 5,000 referrals received in 2021/22, 60% were from those assigned female at birth. Other statistics from the Tavistock confirmed that 48% of the children treated there between 2011 and 2018 displayed autistic behaviour. There are also fears that many who say they are trans may be struggling to come out as gay, as the gathered data stated that 90% were attracted to the same sex.
The Tavistock came under heavy criticism because it was felt that those referred were being placed on a medical pathway towards puberty blockers after a few appointments and without proper mental assessments. Puberty-blocking drugs are administered in regular injections to suppress developmental hormones. Their long-term effects include stunted growth, a reduction in bone density and there are fears they may disrupt brain development in children.
The Tavistock hit back at such criticism and refused to accept that parents and children were not fully informed before making decisions. They stated that nothing irreversible ever occurred but admitted that puberty blockers were given to children of any age who were deemed to have gender dysphoria. This was followed by giving gender-affirming hormones to those aged 16 or over and then gender-affirming surgery at 18 or over. Critics argue that a young person’s brain doesn’t become mature enough to weigh risks until the age of 25, which for some, having surgery beforehand was too late. This also fuelled fears about children and young people who might later decide to de-transition. The media claimed that some had regrets after testosterone had given them deep voices, facial hair, and bigger muscles. Others who proceeded with surgery and had their breasts, uteruses and ovaries removed said that afterwards, they realised that although they no longer looked like women, they hadn’t truly become men either. Some claimed they had made a catastrophic mistake, including those who would have liked children later in life, but their reproductive organs had been removed.
The following case study, “Ben” (not his real name), is based on an interview with a young transman in his early twenties, who lives in Kent, UK. Ben talks candidly about his fulfilled and rewarding life.
I started questioning my gender when I was fourteen. Up until then, I was surrounded by male relatives – my father, brothers, and cousins. I always felt masculine, and I was uncomfortable being around other girls. To make matters worse, I attended an all-girls secondary school which wasn’t overly accepting of queer people. After I discovered Tumblr, I noticed other young people questioning whether they were trans or non-binary, and the thought occurred to me that I might be one of these as well. When I came out to my peers at sixteen, I told them, ‘I’m not a girl’, but did not elaborate any further. I wasn’t ready at that stage to tell my family. Later, when I started university, I identified as non-binary but continued to experiment with my gender by participating in drag acts for fun. I began meeting other people online, including trans men, prompting me to ask myself, ‘Can I be a man and wear a dress and still paint my nails?’ At nineteen, I came out to my brother as a trans man, and he was accepting of this. Two years later, I told my father, but he was less accepting mainly because of his age (late fifties), his past as a serviceman, along with his not being good at ‘doing feelings.’ Much of this mentality is gender essentialism, which reinforces patriarchal ideas about sex and gender and how men and women are expected to be, behave, dress and the roles they take on in society. Even now, he keeps introducing me to people as his ‘daughter’ as well as calling me by my birth name.
Although there have been rapid changes in the trans community over the past six to eight years, change is still slow in some areas. When I first went to my GP, I was surprised to be met with ignorance around trans issues, given the high level of media reporting of it. I got referred to a Gender Identity Clinic (GIC), but only after the GP had researched the process. That was two years ago, and I am still waiting. Even after I get seen, I know there will still be a five- to seven-year waiting list to get placed on hormone treatment, and I’ve heard that clinics rarely check up on people during the referral process or intervening years.
While I identify as a trans man, I still have a female side and will sometimes wear make-up. In the trans community, I occasionally feel uncomfortable being around trans women because I feel guilt for rejecting the gender assigned to me, which was denied to them – and vice versa. Among trans men, there is sometimes jealousy and competition, with some exhibiting hyper-toxic masculinity by going above and beyond to prove themselves to be more masculine than others.
I plan to go to America or Turkey to have top surgery because it is deemed more effective in those countries and more affordable. Any type of trans surgery is expensive and can easily cost £10,000 – many people crowd-fund to raise money to go abroad. Bottom surgery for trans men remains complicated, resulting in few operations. Although technically, it is listed on the NHS, realistically, very few surgeries take place in the UK or indeed elsewhere.
When it comes to finances, sacrifices are often made, with many people feeling they need to choose between having surgery or saving for a deposit for a flat. I am lucky that I have a lot of body hair naturally, along with a deep voice which makes it easier to pass as a man. However, with my gender dysphoria, some days are worse than others if I notice body flaws in the mirror. I hate my tits showing and often change outfits several times to get the right look. Yes, I have anxiety and depression, but some of this arises from issues outside of being trans. I’m not on the autistic spectrum, but I believe there is a link between being trans and having ASD. I would also say there is potentially a strong ASD link within the LGBT+ community per se because a lot of queer people I know have some form of ASD. I know that is only my experience and don’t want to make broad assumptions, but I feel some research should be carried out in this area.
I think de-transitioning is poorly portrayed in the media. Personally, I don’t know anybody who has gone ahead with this. You only need to look at the lengthy waiting lists and the cost of private surgery to know that people are not being rushed into anything. With regards to young people, you must ask if people do not place enough credit and trust in their decision-making. They need to be respected because they know better than anyone else what they truly want. Assumptions are often made (which are not backed up with evidence) that a large percentage of them are making wrong decisions. I agree that young people need to be given time to figure out for themselves if being trans is the only thing going on in their lives. Puberty blockers will help them live in the gender they believe is correct before the physical transition and ensure they have time to consider their sexuality. Proper holistic assessments that help explore all areas of a young person’s life are needed with better access to counselling. All of this will uncover any doubts, especially for those who are considering life-changing surgeries.
I feel we need more education for cisgender people. There is still transphobia and hate in society towards us, making me fear that despite the enormous progress of recent years, things will stop or be taken away from us. I find the debate hideous about trans women using female bathrooms because there is perhaps only one person out of a million who will take advantage and do something horrible – yet this issue is paraded as if there is potential for every trans person to be a sexual predator and/or paedophile. I believe a lot more people will come out as trans. There is room for everyone. We need to create a space where everyone feels welcome.
About the Author
Declan Henry is a creative non-fiction writer and comes from a distinguished academic background. He studied at two of London’s elite universities – Goldsmiths and King’s College. He holds a Bachelor of Arts (Honours) in Education and Community Studies and a Master of Science in Mental Health Social Work. Declan is the author of eight books, two booklets and numerous published articles. He is the bronze winner of the 2017 Independent Publisher Book Award in the LGBT+ non-fiction list for his book Trans Voices – Becoming Who You Are. Declan has written on a wide range of diverse topics, including mental health, young refugees and asylum seekers, transgender people, suicide prevention Gypsies, Roma and Travellers. He is also a reviewer for the New York Journal of Books. Declan was born in County Sligo in the Irish Republic and now lives in Kent. www.declanhenry.co.uk