Fear and Loathing and Trans Joy in Philadelphia

A trip to the Philly Trans Wellness Conference

This year marked the triumphant in-person return of what’s now called the Philly Trans Wellness Conference, which bills itself “the largest transgender health conference in the world.” After going online during and after Covid, the 21^st conference took place the first weekend of September, as a pared-down version of its former self, on a few floors of Temple University’s Gittis Students Center.

I’d attended with two pals, transsexual men with whom I was sharing an Airbnb in the nearby neighborhood: partly-bombed-out, partly working class, partly poorly built modern Airbnbs. My hope was to gain insight into how the more insular rings of the trans community were processing the tumult elsewhere: the revelations of the Cass Review, which had exposed the lack of research supporting gender-affirming care for youth; the president of the American Society of Plastic Surgeons announcing the evidence wasn’t there for gender-affirming care in adolescents; polls suggesting Americans weren’t so gung-ho about natal males competing with natal girls, despite their gender identity. I was also keen to experience this legendary conference, which had always seemed, when I saw videos of it, like a kind of indoor Pride celebration; I’d hoped Jazz Jennings, royal queen of childhood transition, might be there.

Alas, no Jazz, but a newer-on-the-scene trans celebrity took her place. The keynote speaker? Lia Thomas.

Statuesque and personable, with a cascade of candy-red waves and dramatic eyeliner, Thomas spoke—from memory, no note cards—about her (or his, if you prefer) journey to realize her identity. It began with her unabashed love of swimming, the many joys of sport. And then: the realization that desires outside the pool were overwhelming the desires inside it.

She recalled those horrible days when she had to change in the men’s locker room, feeling so exposed and uncomfortable and out of place.

One of my companions scribbled on his conference schedule: “That’s how all the women in the locker room felt!”

Thomas detailed how her parents weren’t on board until they saw 1) how miserable she was trapped in a cis identity and 2) how happy she was once liberated from it—and possibly fully engaging in her autogynephilic delights. She’d initially thought she’d have to choose between transition and competitive swimming. She could have swum recreationally; transition and swum competitively in the male sex category with a hormonal disadvantage; or she could have it all: “transition and swim competitively in the female sex category with a known advantage,” as my companion put it to me.

And, technically, she was allowed to. She’d followed the rules. Everyone applauded and celebrated Thomas’s bravery; not a nod to how that happiness had contributed to so many others’ unhappiness.

One big difference between trans women and women: the former don’t seem to realize that being a woman often means sacrificing, and not having control over your body and destiny.

“Thomas could have taken a step back, turned at the fork in the road, and started a tranny swim club to access and promote those benefits without putting anyone else out,” my companion noted. “That’s part of what’s wrong about today’s trans activism — trans activists are hell bent on making things harder or worse for society at large, rather than making anyone’s life better.”

“That sort of pessimism and negativity was abundant at the conference but it has not always been at the center of trans life,” he added. “I certainly don’t want it at the center of my own.”

I perused a few other workshops: Navigating Sex Work as a Trans Individual; Embarking on a Quest for Connection and Self-Discovery: Gender-Affirming Dungeons & Dragons Group for Trans, Nonbinary, and Gender-Expansive Communities; Kink and Healthcare. Occasionally, I sat near a young woman with kitten ears and a bushy tail.

Whatever workshop I popped into, I heard about the scourge of grown-ups and parents. “Adultism,” was the word, uttered with scorn. How dare an adult assume that they have greater insight into a child’s mind than the child has into their/his/her/xi’s own?

I sat in a session on “21 Ways to Support Your Trans Child.” The workshop was heralded by two therapists, a trans man and a queer woman (meaning: heterosexual), whose slides echoed sentiments I had heard before: believe the child, affirm the child, don’t question the child. I’d come to realize, in seven years of study and reporting, that none of those things were actually healthy or morally correct, and that in fact, when a child expresses gender issues, the first best option was to ignore them. The second-best option was to lift those issues up and see what might be lurking beneath them.

My transsexual conference compatriots believed the same thing. They’d been masculine and gender dysphoric all their lives, but they didn’t consider themselves “trans kids.” They’d made the hard decision as adults to transition, and were happy about it. They were also glad for the hurdles and hoops they’d had to jump over or through, a lifetime of strengthening exercises to prepare them for transition.

The trans man therapist at several points impugned parents, especially those white-cis-het parents whose intersectional identities meant they’d never had any struggles in their lives. Hm, I thought. Can’t you, like, still get cancer or survive sexual abuse or live in poverty or have mental health issues, even if you win the intersectional lottery?

Gingerly, I raised my hand to ask a hypothetical question—one that is very real for many families in America.

“What if I have a trans son, and my father says he doesn’t believe in gender identity? He says he’ll avoid pronouns but won’t affirm, but the son says that makes him feel unsafe? Is there any way to keep the family together?”

A middle-aged white woman a few rows to the left said that keeping the family together was less important than making the child feel safe.

A few rows ahead, another middle-aged white woman answered with more force. “We all know these kids have a high suicide rate,” she cautioned. Cut out anybody you have to, in order to keep the child safe.

Safe. Meaning: kept away from anyone with a different way of looking at the world. Who doesn’t believe or affirm, who questions.

These old school transsexuals I was with—they knew all about what it used to be like when someone would transition and be rejected by their family. So how odd it was to see this new generation tell transitioners to reject their own families. Was that supposed to be some kind of progress—or was it revenge? Those who were once outcasts now had the power to cast out. And maybe, for coddled young people not trained to experience hardship, their struggle muscles sagging and underformed, rejecting their unaffirming families felt strengthening in some way, felt like assuming power but also pain, experiences they’d been robbed of in their overprotected childhoods. Maybe they needed to hurt, and felt justified spreading the hurt around.

Yet another middle-aged white woman took at stab at answering my question. She told the story of her own they/them child, who lived two doors down from their grandparents. Gramma said she didn’t get it, but would gladly affirm because: love! Family! Grampa? Not so much. Didn’t get it, but said he’d avoid the pronouns. It was tense for a while. A long while. Grampa didn’t change all that much—he was old—but he wasn’t a dick about it. And they/them? They eventually decided they didn’t care that much. Being with Grampa mattered more than getting affirmed. “Give it time,” the woman said. “Both of them might change.”

The others didn’t seem to like that answer much. Anything but affirmation raised the risk of the child’s suicide. It was an argument, and a lie, that sealed the conference in indemnification: anything we do is justified.

I attended a top surgery “show and tell” in which about two dozen females removed their shirts to reveal their boobless torsos. Two of them looked, well, perhaps the term is “smoking hot,” all chiseled, their scars hidden beneath muscle and hair. The majority had no nipples; one had a flat chest above an enormous tattoo of the word FREAK. Many were obese, and bemoaned the oppression wrought by the medical system and its unfair focus on fat. A surgeon had explained that the more fat, the longer and harder the healing; it’s not necessarily discrimination. It might be good science. And though no one seemed to accept that, my informal observation was that the de-breasted reporting the most post-surgical complications were also those with the most chub.

Later, I called up yet another transsexual, Buck Angel, to parse what I’d seen. “I’m a transsexual, a person who has a mental disorder called gender dysphoria. I want to present in the world as a man. I don't want anybody to know that I'm a female. So that's what gender dysphoria and transsexualism is. We really try to do as much as we can to mold our bodies in any way we can to what we call ‘pass,’” he told me. What’s going on now, he said, is that “these kids are being pushed into a space of body modification because they are against the establishment.”

“In their transition, they are doing something that is completely opposite of what an actual transsexual person would do. They're not putting nipples on. They have huge scars. They're celebrating their scars.” This was a kind of concept creep that melded full body tattoos and private parts piercings with treatments for gender dysphoria. It wasn’t even just queer theory overtaking the old school binary transsexualism; it was some kind of body mod punk rock rebellion, except institutionalized and covered by insurance—as opposed to surgery for something called satanic serpant implants—devil snake wings?—which run a cool $6,500 and aren’t covered by Cigna. Yet, anyway.

It was normalized weirdness, with weirded normalization, presented as a health care.

I walked the aisles of the exhibitor hall, collecting merch: they/them pronoun buttons, tote bags, a sticker that read, “Pride or die.” “One of our kids made them themselves!” a youth group supervisor said proudly.

An exuberant trans woman offered her homegrown tips for recovering from vaginoplasty, showcasing a sitz bath and a peri bottle: the same items I had used after childbirth. “I had to teach myself how to recover, and I now I want to help others,” she said earnestly. I learned about a shelter for LGBT people seeking asylum—how some people show up in America expecting to be housed by relatives, then are kicked out for being gay. Lots of programs for free HIV testing.

There was indeed a lot of love there, a lot of joy: many who once felt shame, or felt alone, now feeling the warm embrace of community. But the fact that the community was dependent on excommunicating anyone who didn’t bow to the false god of gender identity, wrapped in the ransom note of suicide? That Thomas was celebrated for realizing her own desires to the detriment of so many others? The conference remained as insular and closed off as it encouraged its patrons to be.