Trans Medicine: The Emergence and Practice of Treating Gender
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- Type：Epub+TxT+PDF+Mobi
- Create Date：2021-05-26 09:19:27
- Update Date：2025-09-06
- Status：finish
- Author：Stef M. Shuster
- ISBN：1479899372
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Summary
A rich examination of the history of trans medicine and current day practice
Surfacing in the mid-twentieth century， yet shrouded in social stigma， transgender medicine is now a rapidly growing medical field。 In Trans Medicine， stef shuster makes an important intervention in how we understand the development of this field and how it is being used to "treat" gender identity today。
Drawing on interviews with medical providers as well as ethnographic and archival research， shuster examines how health professionals approach patients who seek gender-affirming care。 From genital reconstructions to hormone injections， the practice of trans medicine charts new medical ground， compelling medical professionals to plan treatments without widescale clinical trials to back them up。 Relying on cultural norms and gut instincts to inform their treatment plans， shuster shows how medical providers' lack of clinical experience and scientific research undermines their ability to interact with patients， craft treatment plans， and make medical decisions。 This situation defies how providers are trained to work with patients and creates uncertainty。 As providers navigate the developing knowledge surrounding the medical care of trans folk， Trans Medicine offers a rare opportunity to understand how providers make decisions while facing challenges to their expertise and， in the process， have acquired authority not only over clinical outcomes， but over gender itself。
Surfacing in the mid-twentieth century， yet shrouded in social stigma， transgender medicine is now a rapidly growing medical field。 In Trans Medicine， stef shuster makes an important intervention in how we understand the development of this field and how it is being used to "treat" gender identity today。
Drawing on interviews with medical providers as well as ethnographic and archival research， shuster examines how health professionals approach patients who seek gender-affirming care。 From genital reconstructions to hormone injections， the practice of trans medicine charts new medical ground， compelling medical professionals to plan treatments without widescale clinical trials to back them up。 Relying on cultural norms and gut instincts to inform their treatment plans， shuster shows how medical providers' lack of clinical experience and scientific research undermines their ability to interact with patients， craft treatment plans， and make medical decisions。 This situation defies how providers are trained to work with patients and creates uncertainty。 As providers navigate the developing knowledge surrounding the medical care of trans folk， Trans Medicine offers a rare opportunity to understand how providers make decisions while facing challenges to their expertise and， in the process， have acquired authority not only over clinical outcomes， but over gender itself。
Reviews
Grayson
，
I am a trans person who is medically transitioning， and have read many books about trans medicine， but this is the first I have found by a trans person。 There is a huge issue with trans issues and stories being told by cis people， so I loved this book！ It provided incredibly valuable insight as someone who does not work in the medical field but is greatly affected by it。 It opened my eyes to alot of issues and changed some of my opinions on trans medicine I held before reading。 Before reading I I am a trans person who is medically transitioning， and have read many books about trans medicine， but this is the first I have found by a trans person。 There is a huge issue with trans issues and stories being told by cis people， so I loved this book！ It provided incredibly valuable insight as someone who does not work in the medical field but is greatly affected by it。 It opened my eyes to alot of issues and changed some of my opinions on trans medicine I held before reading。 Before reading I just kinda assumed the rules put in place on trans medicine was for the patients benefit， but this book opened my eyes to just how much of a power imbalance their is between trans patients and their providers， as well has just how many expectations and requirements are put onto trans patients that are unneeded。 I wish dates were provided with each bit of medicine because this is a quickly evolving field and there were a few bits that seemed a bit outdated already。 Also， I wish this book acknowledged detransitioning， because while rare does greatly impact how the medical field treats trans patients。 And as a trans person I feel like theres a stigma around talking about detransitioning when it comes to medicine as if it discredits trans people， but I find it an important topic to discuss in these conversations。This is a book I recommend for both medical providers and trans people looking to transition。 I already recommended this to a friend in medical school and my therapist！ 。。。more
TimInCalifornia
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A well-researched look at gender-affirming medical care， including therapy， in the United States。 The author， who is themself a non-binary trans person， puts a focus on the lived experiences of current medical providers of gender affirming care。 To illuminate present day practices， Shuster traces the history of medical care in this area starting in the mid-20th century。 While I was familiar with the broad outlines of the care （and barriers to care） to my generational trans pioneers， the detailed A well-researched look at gender-affirming medical care， including therapy， in the United States。 The author， who is themself a non-binary trans person， puts a focus on the lived experiences of current medical providers of gender affirming care。 To illuminate present day practices， Shuster traces the history of medical care in this area starting in the mid-20th century。 While I was familiar with the broad outlines of the care （and barriers to care） to my generational trans pioneers， the detailed research of medical and psychiatric notes， particularly the correspondence between the few medical professionals at that time who worked with trans patients， was illuminating in ways both good and sad。This book does not discuss specific treatments or procedures or make any recommendations of that nature， nor does it look at the evolution of medical interventions， except as such related to the decision-making process。 The purpose of this book was to look at the professional lives of the medical practitioners and how they understand their trans patients， their role in providing care， their obligations to their professional standards， oaths， and statutory laws， and how they coalesce all this into arriving at a specific decision or a road map for care of a trans patient/client。Shuster is an academic but the writing was very accessible for a layperson such as myself， infused with just enough academic-style to make me feel smart。 I first accessed gender-related medical care in the late 1990s。 Being in an urban area， I was able to find a general practitioner who， while she was not terribly experienced with trans patients （who was？）， she was willing to learn。 She taught me the value of engaging in frank conversations with one’s doctor and I was lucky that she initiated the approach that we were learning on this journey together， sharing knowledge and resources。 This was an excellent life skill to have developed and I have used it in the 20+ years since when accessing medical care for any reason， not just gender-related care。 Articulating questions， engaging with your doctor on your own healthcare plan， drawing on their knowledge for your own good， is excellent self-care。 Most doctors have been receptive， some taken aback， but I happily have not had an outright negative experience。Reading this book gave me a larger appreciation of the professional position and the professional world of medical care providers。 I truly had not given active consideration to their obligations beyond the care plan that is devised for me; in addition to my care， they need to think about their medical license， FDA recommended vs。 off-label use of drugs， how comfortable they are working outside their expertise， especially when gold-level studies and research are few to none。 All this is in their minds as they consider me and my needs as a patient。This book also crystallized for me something I already somewhat grasped。 My lack of an “outright negative experience” has a lot to do with my race and class and my clear understanding of my gender and ability to communicate it in a way that a doctor in the U。S。 can get comfortable with。 My gender identity （and frankly my desired lifestyle） falls into society’s normative experience of a （gay） male。 I’m lucky that my desired life and self-expression met “acceptable” expectations as the barriers to care for those outside the “acceptable” continue， often for the same reasons barriers to care existed some 50-60 years ago。Recommended reading for medical professionals and for trans patients seeking care， most especially for trans persons （including non-binary persons）， as it can help in our self-advocacy to appreciate and understand decision-making the medical field。 It was particularly interesting to see how in some ways the changes in approach to trans medical care， and the role of doctors， is a microcosm of changes in the medical profession altogether。 Also interesting was learning of the uneasy relationship between medical doctors and psychiatrists and between psychiatrists and therapists。 I have to say that reading the excerpts and quotes of some of the correspondence， particularly in the earlier years， is disconcerting。 I have such a clear and untroubled sense of myself and identity and even now， after so many years， it’s disheartening to read how murky and troubling I am， my being-ness is， to others。 Well-done with kudos to Stef Shuster and a thank you to #netgalley and New York University Press for the advance reader copy。 。。。more
Colin
，
Focused on the historical and contemporary role of physicians， psychiatrists， and psychologists navigating the uncertainty around gender transition， I found this read to be intensely academic。 I felt as though I were reading a dissertation， which is not neccesarily a bad thing， as it is clearly researched， informative， authoritative， and well-cited above all… though difficult to not go bleary-eyed at times。 I felt the publisher summary was a bit misleading in this regard。 This is a useful resour Focused on the historical and contemporary role of physicians， psychiatrists， and psychologists navigating the uncertainty around gender transition， I found this read to be intensely academic。 I felt as though I were reading a dissertation， which is not neccesarily a bad thing， as it is clearly researched， informative， authoritative， and well-cited above all… though difficult to not go bleary-eyed at times。 I felt the publisher summary was a bit misleading in this regard。 This is a useful resource for a student or sociological or medical professional and would make for excellent industry conference material， but not as meaningfully accessible for the general public。 While the research and argument were clearly presented， I wish this book had included greater reflections from the author or the trans community itself， which would have made it more approachable， and not just the perspective of the provider-side。I had trouble rating this book。 If you’re researching for a paper or presentation， this is a great resource。 If your goal （as mine was） is to better understand the trans experience， a summary of concepts from this book might suffice。ARC provided by NetGalley in exchange for an honest review。 。。。more
David
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Wonderful book covering the evolution of trans medicine and the current practice。 Very well structured and nicely documented。 I was expecting a much more academical read， but I am positively surprised about how accessible is。Very often we take science and the medical discourse as unquestionable。 But science is indeed about questioning， and that is exactly what this book does: opening up the debate on how the pathologization of trans identities was built through the 20th century to our days。Some Wonderful book covering the evolution of trans medicine and the current practice。 Very well structured and nicely documented。 I was expecting a much more academical read， but I am positively surprised about how accessible is。Very often we take science and the medical discourse as unquestionable。 But science is indeed about questioning， and that is exactly what this book does: opening up the debate on how the pathologization of trans identities was built through the 20th century to our days。Some of the most interesting points that I recall are:t•tThe chronological analysis， showing the construction of a narrative not only to control trans bodies and lives through medicine， but also building some of the prejudices trans people face still nowadays， at least in Spain。•tThe ‘legitimacy wars’ between physicians and therapists， as well as the clashes they had on the definitions and treatment for trans people at the time。•tThe random construction of protocols based on providers’ personal criteria that have survived over time， impacting in trans lives today。 An example of this is providers’ expectation for trans people to align with their gender roles and gender norms’ ideas， which still happens currently – despite the lack of science backing these prejudices。•tThe “real life test” （asking trans patients to live their life as if they had already physically transition， but without the aid of hormones or surgery） is another unscientific approach taken by providers that we can still see nowadays in many countries， where trans people are expected to wait for a given amount of time before they are provided with hormones or access to surgical interventions。•tHow regret is weaponized by “pro-life” activists against abortion， using potential regret of the person who has an abortion to fight against abortion itself。 It seems providers are also concerned by trans people regretting their transitions， which is also weaponized by transphobes very often to fight against trans access to hormones or surgery。The only aspect I missed a little bit the book to cover were interviews with trans people。 What are their views on the current way medicine treats them？ How the different approaches taken by providers （flexible interpreters and close followers， as the author names them） impacts on them？ I would have loved having their voices included here。 In short， could we move the spotlight to the way that medicine is pathologizing trans identities （without scientific evidence） and finally move forward towards trans liberation？ 。。。more
Karen
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This is a sociological study of the ways medical providers （doctors and therapists） approach medical care for trans people。 A lot of it is horrifying， such viewing non-binary people as not having a stable identity and therefore not good candidates for any physical changes。 There is so much paternalism and judgment from the doctors， and these are the ones who want to help！ I was unsure who the audience was for this book。 I don't know that it would be useful for a trans person to read， any more th This is a sociological study of the ways medical providers （doctors and therapists） approach medical care for trans people。 A lot of it is horrifying， such viewing non-binary people as not having a stable identity and therefore not good candidates for any physical changes。 There is so much paternalism and judgment from the doctors， and these are the ones who want to help！ I was unsure who the audience was for this book。 I don't know that it would be useful for a trans person to read， any more than a black person would want to read a book of white people saying racist things。 But I do think it's good that it exists， that it is making medical discourse and mindsets visible to people who aren't in that field。 It was interesting reading the quotes from the supportive doctors who genuinely didn't know what to do， because prescribing hormones to help someone transition is considered "off-label" and is not well studied。 I wish there had been more to this book， both more data and more theory。 It felt like she was publishing a dissertation。 。。。more
Robyn
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