Transsexual Recognition: Embodiment, Bodily Aesthetics and the Medicolegal System Zowie Davy Submitted in accordance with the requirements for the degree of Doctor of Philosophy University of Leeds Centre for Interdisciplinary Gender Studies September 2008 - The candidate confirms that the work submitted is her own and that appropriate credit has been given where reference has been made to the work of others. This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. Acknowledgements This thesis would not have been possible without many people who were directly and indirectly involved in the research. I would like to thank my PhD supervisors, Professor Ruth Holiday and Professor Sasha Roseneil, who have painstakingly committed to this project and helped me clarify ideas, guided me, picked up on my idiosyncrasies and taught me more than I ever would have dreamed. I am indebted to all the participants, who offered the most intimate details of their lives and hope that I have done them justice. I will be eternally grateful to the Economic and Social Research Council (ESRC) for the 1+3 scholarship that enabled me to start my postgraduate studies. I would like to thank Emma Nelson, who all them years ago eased me into to the Centre for Interdisciplinary Gender Studies at the University of Leeds, with such care and professionalism, and made my life at postgraduate level so enjoyable. Matthew, the new office manager has also helped in assisting me with forms, finances and so on, which is greatly appreciated. I would like to thank (in no particular order) Ana Cristina Santos and Fernando Fontes for being such brilliant friends and housemates, for their encouragement and support and for listening when I became fearful of the unknown. I also want to thank them for the fun times we have had during this turbulent "PhD-time. " I also wish to thank Fiona Phillip, for extending my English language skills and being a friend who likes some time out for drinking and debating, KT Russell for being such a great actor and helping me have a little more of a work/life balance. I am indebted to Zoe Thompson, Lena Eckert, Dario Llinares, Natalia Gerodetti, Sue, Shirley Tate, Sally Hines, David Bell, Julia Downes, Sharon Elley from CIGS and beyond, for being been supportive friends in their own ways and I hope to continue the friendships that have been nurtured. I appreciate the support from various members of staff at the University of Leeds and the University of Bradford who have given me the opportunity to gain teaching and research experience (and some extra money), Teela Sanders, Ian Burkitt, Shona Hunter, Simon Prideaux, Moira Doolan. And others who have taught me so much, Griselda Pollock, Denis Flannery, Tracy Hargreaves, and many more. I would like to thank Paula Thorpe and Vic Davies who have been there as my friends and confidents, through the hard times and the good times, their support has been unwavering even when things got really tough. I would like also to thank my family James Royston Davy, Pauline Davy, Steven, Frances, Christopher and Elizabeth Davy and John Davy, my nana Eileen Toes and my aunt Linda, who have been sources of encouragement. I hope the one's who are no longer with us would be as proud of my work as I am to be a part of this family. 1 Abstract This thesis develops recent work on transsexual/gender embodiment that has emerged from the field of transgender studies. The empirical study has been influenced by poststructuralist theory and feminist phenomenology and focuses on the constructed personal meanings of embodiment and bodily aesthetics for transpeople. Furthermore the thesis explores how trans embodiment is constructed within the medicolegal system and transgender politics in the United Kingdom. This study reviews the medical and legal work on transsexuality, which forms the basis. of being recognised in law as either (trans) men or (trans) women and how medical theories and legal prescriptions have been adapted through time on the basis of trans bodily aesthetics. Transmen and transwomen's personal bodily aesthetics are discursively and materially constructed and recognised through body images of the "phenomenological, " "sexual" and "social body, " which all provide for understandings surrounding their gender identities. Moreover, the thesis investigates how embodiment and bodily aesthetics are framed in three Transgender Community Organisations (T-COs). The epistemological approach of phenomenology in this thesis allows for detailed descriptions surrounding the diverse bodily practices of the trans participants, and their experiences with the medicolegal system and T-COs. The study employed semi-structured interviews and photograph elicitation methods with fourteen transwomen, eight transmen and one person who had had male to female SRS but had decided to live as "bi-gendered. " The age range of the sample ranged from twenty two to sixty years old, who were at different stages of transition, and who all recognise themselves as being of a different gender to that which was given at birth. The thesis identifies diverse embodied practices by transpeople, which all help constitute a commitment to a specific gender identity. These findings challenge the traditional medical models, which constitutes the "true transsexual" as always requiring a normative bodily aesthetic. I consider the processes of attaining a masculine or feminine body and how different discourses of embodiment are 'utilised or challenged and how imaginatively anticipated bodies are actualised through technology. The thesis argues that transmen and transwomen differ in their engagement with technology and discourses of embodiment of the self, within transgender politics and within the medicolegal system. Furthermore, it suggests that bodily aesthetics are important aspects of lived experience in relation to transpeople's phenomenological, sexual and social selves. 11 Table of Contents Acknowledgements i Abstract ii Table of contents iii Part I: Constructed Bodily Aesthetics Introduction Introduction: Bodies in Focus 1 Situating the thesis 8 Chapter outline 12 Chapter I: Shifting the Medicolegal Constructions of Transsexuals' Bodily Aesthetics Introduction 15 Establishing the terminology 16 Diagnoses and "Practices of Care": psychology and psychoanalysis 22 Judging the efficacy of treatment 27 Queer(y)ing the clinical gaze 28 The medicolegal alliance: Or, does `biological' sex equal legal sex? 32 Recognising gender and the changing medicolegal gaze 40 Conclusion 45 Chapter II: Theorising Trans Embodiment and Bodily Aesthetics Introduction 47 Radical feminism and trans embodiment 48 Transgendertalking back 52 Cartesianthinking and the "wrong body" trope 55 Post-feminism, reflexive agency and financial considerations 59 Transgenderbody projects from inside out and outside out 62 Symbolic interactions: passing and non-passing bodies 64 Interacting with Garfinkel 69 Phenomenologyin transgenderstudies 70 Leaning on feminist phenomenology 75 Conclusion 77 Chapter III: Methods, Methodology and the Research Process Epistemological and analytical approach 78 Designing the research and reflecting on methods 80 Access, sampling and selection 82 The sample and other demographics 84 Pen portraits 85 Pen portraits of Trans-Community Organisations (T-CO) 88 Interviewing the participants 90 111 Limitations of the research 90 Analysing the interviews 93 Ethical considerations 95 Part II: Personal Bodily Aesthetics Chapter IV: Recognising the Self: Transmen's Body Projects Introduction 97 Childhood, puberty and sex differentiation 98 Decision making and transitioning 105 Hormones: masculinity from inside out and outside in 113 Producing ideal bodies 118 Surgical outcomes and aesthetic conciliations in different spaces 121 Negotiating masculinities 129 Conclusion 132 Chapter V: Recognising the Self: Transwomen's Body Projects Introduction 134 Childhood re-envisions 134 Decision making process 138 Penis as a male signifier 146 Gendered clothing and make-up 149 Hormones, emotionality and `beauty' 158 Genital surgery and aesthetic surgery 162 Conclusion 169 Part III: Negotiating Bodily Aesthetics Chapter VI: Framing Bodies in Trans-Community Organisations (T-CO) in the UK Introduction 171 Methods 175 Framing bodies in a biogenetic paradigm 176 Making a convincing argument 183 Inadvertently framing bodies through a medicolegal frame? 186 "Get off my representation! " Aesthetic formulations of transgender 190 Sexing it up 197 Conclusion 198 Chapter VII: Negotiating Authenticity and Bodily Aesthetics within the UK's Medicolegal System Introduction 200 Gender recognition through the medical gaze(s) 201 Consumer rights and NHS provision: authentic vs. cosmetic 205 iv 212 Hormones as a diagnostic tool in private care Money, treatment and agency 214 NHS gender clinics past and present and the age factor 217 Authenticity and authentication 218 Gender recognition and the "medicolegal alliance" 222 227 Concluding remarks Conclusion: A Springboard from which to Leap From aetiology to management 229 Moving beyond dichotomies 231 The (diverse) phenomenology of trans bodily aesthetics 232 Building bridges over the political ravine 235 Agency and authenticity in context 235 Where to now? 236 References 238 Appendices Call for Participants 251 Participant Information Sheet 252 V Introduction: Bodies in focus This thesis explores transpeople's embodiment and bodily aesthetics.