Preface: As an essayist or columnist for several print and online publications, I have made no secret of my biases; freedom granted to me by the very nature of my profession and, in fact, often encouraged by my generous editors. However, as a journalist, there is an innate instinct to identify and share my preconceptions with my readers. In this case, I believe highlighting my stake in this essay is necessary.

I am a trans woman.

I knew I was trans from a very young age. I have fully transitioned and have lived cheerfully and successfully as a woman for nearly as long as I have lived as the other.

While I would like to imagine that my passion for truth-telling would supersede my instinct to colour what follows below, I suspect that my own wish to write about this topic has been impacted by my own experience and wish to see the successful transition and outcomes of other trans and queer individuals.

This essay is about the rise of disinformation framed around the trans community and gender-affirming care. Had I not been coloured by my own experiences, I suspect that I would mimic the patterns and behaviour of legacy media and just not talk about this at all, but I can’t tolerate this indifference and ongoing war on my marginalized, vulnerable community.

In future posts, I will talk in greater depth about the stages (or types) of transition, but here, for our purposes today, I feel it is essential to set the record straight on gender-affirming care and how this medical protocol is changing lives and resulting in better health and economic outcomes for trans women, men, and individuals.

THE RISE OF DISINFORMATION

Of all of my stated goals, online and off, is to act as a dogged barrier against the rise of misinformation. This begins with the rise of false and misleading information about the trans community (and individuals) and extends past the many misunderstandings of the laws and legal system in Canada, and I will push back against this scourge wherever and whenever I can.

The malicious sharing of false or intentionally misleading information goes beyond just a simple nuisance. This growing trend can, and is, resulting in actual harm to our community, the trans community, and genuine damage to individuals.

The rise in disinformation poses an existential threat to society in various ways. Some of the key ways in which it can harm include:

Eroding trust, meaning disinformation, undermines trust in institutions, media, and interpersonal relationships. When people are exposed to false or misleading information regularly, they may become skeptical and cynical, making it difficult to trust information sources.

We’ve seen that this deliberate act can also manipulate public opinion. Disinformation campaigns can work public opinion, swaying individuals’ beliefs and attitudes. This can severely affect democratic processes, influencing elections, policy decisions, and public discourse. The U.S. has used this tactic for decades to sew social division in a targeted nation or community (for economic or political gain). Recently, some foreign bad actors (China, Russia, Iran, etc.) have turned the tables on the U.S. and have even launched campaigns of misinformation right here in Canada.

Disinformation often targets sensitive topics, amplifying existing societal divisions. It can contribute to the polarization of communities, fostering an “us vs. them” mentality. This can lead to increased social tension, animosity, and even violence.

In the context of health, disinformation can spread false or misleading information about medical treatments, vaccines, and public health measures. This can have severe consequences, as seen during public health crises, where inaccurate information may discourage people from taking necessary actions or following expert advice.

Today, though, I want to talk about how misinformation impacts health issues and outcomes in the trans community and considering it is trans awareness week, I want to share the proven science behind gender-affirming care.

WHAT IS GENDER-AFFIRMING CARE?

Gender-affirming care (GAC) refers to medical, psychological, and social support for individuals undergoing gender transition. This type of care is specifically designed to help transgender and gender-nonconforming people align their physical and social selves with their gender identity. Gender identity refers to an individual’s deeply felt sense of their own gender, which may or may not align with the sex assigned to them at birth.

Gender-affirming care can encompass a range of services and interventions, depending on an individual’s needs and preferences. 

Some standard components include:

Hormone Therapy: For those seeking a more congruent hormonal profile with their gender identity, hormone therapy may be prescribed. This can involve the administration of hormones such as estrogen and anti-androgens for individuals assigned male at birth transitioning to female or testosterone for those assigned female at birth transitioning to male.

Surgery: Some individuals may pursue gender-affirming surgeries (also known as gender confirmation or gender reassignment surgeries) to alter their physical characteristics to align with their gender identity. Surgical options can include chest/breast augmentation or reduction, facial feminization or masculinization surgeries, and genital reconstruction surgeries.

Mental Health Support: Mental health services, including counselling and therapy, are crucial to gender-affirming care. These services can help individuals navigate the emotional and psychological aspects of their gender identity and the challenges associated with gender transition.

Social Support: Gender-affirming care often involves creating a supportive social environment. This can include assistance with changing names and gender markers on identification documents, support in coming out to friends and family, and guidance on navigating social situations in a way that affirms one’s gender identity.

Voice and Communication Training: Some individuals may seek assistance developing a voice and communication style that aligns with their gender identity.

It’s important to note that gender-affirming care is highly individualized; not all individuals will pursue the same interventions. The approach to gender transition is a personal decision, and healthcare providers work collaboratively with individuals to develop a care plan that meets their unique needs and goals.

Access to gender-affirming care is a vital aspect of promoting the health and well-being of transgender and gender-nonconforming individuals.

PART 3 – NO PERMISSION NEEDED: What Was Once Shame Has Become Pride

What began as innocent play, the joy of dressing up and pretending, soon curdled into confusion and punishment. My parents’ gentle corrections hardened into anger, their voices faltering with something more akin to unrelenting impatience. My pleas — small, wordless, desperate — were dismissed as misbehaviour. How could I have explained, at four or five…

Sabrina Constance Hill's avatar by Sabrina Constance Hill

PART 2 – SHAPE OF BECOMING: Grief, Legacy, and Inheriting Her Echo

Grief is a complex journey, shaping identity through loss and memory. Sabrina reflects on her relationship with her mother, navigating absence, longing, and legacy. While struggling to inherit her traits, they ultimately find strength and validation in her mother’s enduring voice, guiding them towards self-acceptance and growth.

Sabrina Constance Hill's avatar by Sabrina Constance Hill

Over the last decade, we have seen a lot of misleading information, usually willfully and with malicious intent, but some of it is born out of passivity, and this has resulted in the construction and persistence of a narrative that is inaccurate around why some go through GAC and what happens when they do.

There are many reasons why someone may feel that their gender is actually unlike what they may have been assigned at birth. Answering how or why someone may be trans or the path that they got there is complex and unique to each individual. There are several theories about the physiological, psychological, or neurological causes that may lead people such as myself to believe that their gender differs from that which they are assigned at birth. There are credible theories that suggest chemical or hormonal levels during pregnancies, chromosomal or genetic “abnormalities,” or other yet unidentified environmental causes.

In 2022, a study was published on the mental health outcomes of transgender and non-binary youths receiving gender-affirming care. (Click Here). Its object was to investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality. The results were not surprising to me, but the researchers found that by the end of the study, 69 youths (66.3%) had received puberty blockers, gender-affirming hormones, or both interventions, while 35 youths had not received either intervention (33.7%). They observed 60% lower odds of depression and 73% lower odds of suicidality among youths who had initiated puberty blockers or gender-affirming hormones compared with youths who had not. There was no association between PBs or GAHs and anxiety.

Their conclusions were that gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months. This data add to existing evidence suggesting that gender-affirming care may be associated with improved well-being among TNB youths over a short period, which is essential given the mental health disparities experienced by this population, particularly the high levels of self-harm and suicide. This isn’t the only study that reaffirms that providing GAC leads to better outcomes for the trans community.

All of the right-wing media and countless transphobic social media influencers would have you believe that either “no science exists” or that it is “being manipulated by some murky cabal of pro-trans libs.” From this, they then demand that life-saving gender-affirming care, under the careful supervision of licensed medical practitioners and parents, should be outlawed. It is this opinion that is unsubstantiated and destructive. Based on some stone-aged religious dogma and personal incredulity, transphobes are harassing elected officials into considering banning this vital medical care. 

My message to those in the trans community: We cannot wait and rely on cis-allies in the media to be our advocates. We must advocate for ourselves using passion, reason, and evidence-based science.

My message to parents: Parents should give the child permission to explore gender and indicate that this is something that they are comfortable learning about and discussing. Then, I would encourage parents to educate themselves using the many resources available today, both online and offline, and consider talking with other families with children who are also gender nonconforming. I would also encourage parents to obtain clinical consultation from a provider knowledgeable in transgender health.

My advice to all of you, and especially to those in positions of power and influence: To address the rise and weaponization of misinformation, individuals must develop critical thinking skills, for media organizations to uphold journalistic standards, and for governments and tech platforms to implement measures to curb the spread of disinformation. Promoting media literacy and fact-checking initiatives can also play a vital role in mitigating the impact of disinformation on society.