I'll admit it: a coworker once stormed out of the medical school cafeteria in tears because of something I said. They were a "they," sporting a man's button-down that strained across their chest, and they hated me. Our clash that day? The very purpose of therapy.
A young patient, another "they/them," had been placed on testosterone by our clinic. They were seeing a therapist we'd recommended, and their constant complaint was the world's refusal to use their pronouns while simultaneously seeing them as trans masculine, despite their insistence on keeping their birth name. They lamented the terrible oppression they faced because of this. Finally, the therapist asked a simple question: "Have you considered changing your first name to something more masculine if it's causing you so much distress?"
Chaos ensued. The child stormed out, the parent complained to me, demanding I help "cancel" the therapist and remove her from our referral list. I refused. My "they/them" coworker believed I wasn't just wrong, but that I was perpetuating violence against the patient by supporting therapy that dared challenge a patient's thinking. They demanded my head, demanded a struggle session (which the university provided), but I refused to agree. They declared I wasn't a "safe person." And thus, the hatred deepened. This, my friends, is a symptom of a larger problem, one that has seeped into our politics, into the very fabric of our discourse. This is why the democrats lost.
Barbara Kingsolver, in the Poisonwood Bible, wrote, "Conquest and liberation and democracy and divorce are words that mean squat, basically, when you have hungry children, clothes to get out on the line and it looks like rain."
Class Matters
At the time, I lived in a house with a small beautiful kitchen, sunlight streaming through the windows. But when gunshots rang out nearby, my older kids knew to hit the floor and army crawl to the basement. When my toddler imitated them, I knew it was time to move. When you live on a block where homes look bombed out, where people nod off on heroin, you don't need a liberal arts degree to know what "safe" really means. You also don't have the luxury of caring about ze/zer pronouns. We didn't go out of our way to make things more dangerous or dumber; we just walked the long way around the open-air drug market with our kids.
I won't bore you with a sob story about my working-class background, but I know what it means to be poor. I know the anxiety of using WIC at the grocery store, setting up dividers between necessities and wish-list items. I know how to make stock from vegetable scraps and jam from in season fruit. I've been there.
People ask why I blew the whistle on the gender clinic when others wouldn't. I used to think it was because others were LGB or T. Now, I believe it was about class. It was me and a nurse who really questioned what was happening. Our common ground? We were the lowest paid in the center, teetering on the edge of the professional clinical class. After I spoke out, some tried to discredit me by saying I was "just a secretary." They were trying to dismiss the intelligence of medical secretaries, as if their lower pay grade somehow correlated with lower intellect. That's bullshit. Medical secretaries run circles around doctors in insurance billing, they know the best specialists, and they often understand their division's medical care better than a general pediatrician.
The nurse and I both lived in rough neighborhoods. We knew sleepless nights punctuated by gunfire. We rode the city bus, sharing cars with spouses. When COVID hit, we understood the reality for families whose kids relied on school for breakfast and lunch. Our children went to failing city schools where soap and paper towels were a luxury, where there certainly wasn't time for a puppet show sing-along about gender.
When I dug into the gender center data, I saw a pattern: an epidemic of privileged, primarily white kids from upper-middle-class zip codes, areas with reliable internet and iPhones for every child. Schools with soap, paper towels, and ample time for gender identity workbooks. But also, kids whose lives were so sterile, so sheltered, that they had to create their own oppression. They had to invent the "trans within".
Wealthy doctors seemed oblivious when we pointed out that patients weren't meeting basic milestones of adolescence. A poor or working-class person understands the damage of dropping out of high school, that without a diploma, you can't even get a job making pizzas. They seemed similarly unconcerned that these same kids weren't getting driver's licenses. You can't deliver the pizzas without a license.
This is where the ivory tower ideology crashes into the real world. Families in failing schools hear about yet another trans kid in middle school. Families with incarcerated loved ones, knowing they can't get basic dental care, hear about prisoners receiving sex reassignment surgery. Call me a Midwestern working-class idiot, but I don't buy that Judith Butler's academic jargon is dismantling the class system. It's academia dictating culture to the proletariat. We make our own, fuck you very much.
I've always been for working-class revolt. I meant it when I wrote in that Free Press article that I was left of Bernie Sanders because that left used to represent the poor. If this is a working-class revolt against ivory tower elitism, then I'm all for it.
Pronoun rituals are bougie.
Having your thinking challenged is a necessity.
And no child is trans.
The end.