Most blind people who have spent any time dealing with medical professionals have learned to expect some very bizarre questions. Experienced practitioners can sometimes seem disconcertingly ill-informed as soon as disability is involved. Trained as we are to place vision at the centre of the human experience, it’s not all that surprising that even the experts think blind people can’t, say, live a normal life, or experience romantic attraction, or independently express their own identity.

Elise Johnston, a prodigiously talented trans writer who has been blind from an early age, has graciously agreed to share her own experience with the “smart people, silly questions” phenomenon. I hope her story will make you laugh and, more importantly, get you thinking about how and why medical professionals–the ones authorized to make life-changing decisions for us–assume that people without sight are people without understanding.

“So,” the psychiatrist asks you, in a delicate, hushed voice, “as a blind person, how can you be transgender?”

Pause. Breathe. Collect thoughts. Ignore impulse to scream like tea kettle.

You know how you’re sitting on this couch, petting the psychiatrist’s snuffling Boston terrier and telling your heart, “No, it’s not a good idea to jump out of mouth. That won’t bode well for getting the letter of recommendation for gender affirmation surgery. That’s the reason for being here, remember?” You know about this, right?

And you know weird questions might be coming because this dude just gives off that vibe. Also, you’re blind, and blindness makes smart people say stupid things.

But compared to able-bodied cisgender dudes with the power to make or break the lives of desperate patients, what the hell do you really know, right? Right?

“Wait,” says Meagan, reading the first draft of this blog post, “I doubt all of my readers know this gender jargon.”

Fine. I’ll explain.

[Trigger warning: special rainbow snowflake words and concepts follow. Hang on to your pearls.]

Gender

First of all, take the equipment out of the picture. That’s biological sex, not gender.

Okay, so find some new parents and watch how they treat their baby. Blue balloons or pink? Barbies or trucks? Ballet or soccer practice? “She’ll break hearts” or “he’ll go places?” That’s gender. Sure, there are beautiful exceptions to the binary, but that’s the general pattern, the pattern of gender as we know it.

Lest there be lingering confusion, gender is not about who you’re attracted to (or not attracted to), and has no specific relationship to sexual orientation. So forget about sex. That’s what I’ve done most of my life. Which leads us nicely to…

Dysphoria

Imagine you step in a rain puddle and soak your socks. And you’re not allowed to change your socks for the rest of your life. And every time you go somewhere, you step in a new puddle and soak your socks again.

Now imagine that your sock is your body and the puddle is your family, friends, teachers, employers, neighbours, everybody. They’re always drenching you in cold wetness. They can do this by calling you a name that doesn’t fit or using a pronoun that doesn’t fit.

If you don’t have an imagination—let’s face it, so many of us don’t—ask everyone in your life to use the opposite pronouns when talking about you and call you a name that’s not traditionally associated with your gender. Feels weird, right?

This weirdness is called misgendering, and the feeling of constant intense discomfort is called dysphoria.

Transgender vs. Cisgender

Everybody is assigned a gender based on whether they have a penis or a vagina when they’re born. “Let’s just forget about the huge number of people who have neither or a mixture of both,” says the doctor.

If what the doctor says agrees with you on the fundamental existential level, then hurray! You’re cisgender. You can go about your life discovering other interesting challenges to occupy you until death, like deciding how best to troll Meagan’s blog.

If the doctor’s assignment feels entirely, devastatingly mismatched, if you live with permanent feelings of depression and wet-sock misery, then you might be transgender, and wish to pursue transitioning.

Transitioning

This is when a transgender person explores a gender other than the one they were arbitrarily assigned. They might try on their siblings’ clothes, prompting disgust and anger and plenty of parental panic. If they have facial hair, they might burn it off with lasers or electricity. They might pursue gender affirmation surgery to help with dysphoric feelings, and get to deal with gatekeepers like our fine psychiatrist friend.

They may also take estrogen or testosterone. These can cause breast development or lower the pitch of the voice, among other marvelous things. Think puberty.

Back to My Story…

I presented the psychiatrist and his dog with my favourite transformation metaphor, with much solemn throat-clearing:

“When I was a young caterpillar, I despaired of my fuzziness, especially when said fuzziness appeared on my face. I longed to grow breasts—I mean wings—and take to the sky as the butterfly I felt like on my rainbow insides. Life was a tipsy wheelbarrow, full of loneliness and despair, tossed about on a stormy sea, sailing downhill toward Suicide Lake.”

It’s the same story I’ve told my parents, my friends, my therapist, that other psychiatrist, the GP who prescribes my hormones.

Except, then came the curveball, the weird question to end all weird questions. Here it is again, just for effect:

“So, as a blind person, how can you be transgender?” he asked. “Like if you can’t see women, how can you possibly know that you want to be one?”

Oh dear, I thought, I have just boarded the elevator of wrongness, and this elevator music is a symphony of shit. Let’s break it down:

This PhD thinks blind people can’t grasp gender like a sighted person can.

This credentialed, respected, supposedly woke expert thinks one must see woman to know woman.

Anyway, because I have access to someone else’s blog, and words are free, here’s what I told the psychiatrist. Maybe you might identify with some of it, especially if, like me, you don’t tend to base your idea of gender on how people look, invalidating the lives of blind people everywhere.

Firstly, in my world at least, gender isn’t biological. It’s not a matter of body, it’s a matter of brain. Or maybe it’s my gut? Or my heart? My bones?

I’ve been convinced for as long as I can remember that I am a woman, making one of the assumed premises of the psychiatrist’s question invalid: I don’t want to be a woman; I am a woman. What I want is an exterior that matches my interior, and I don’t need sight to be sure of that.

Secondly, my experience of gender is one of relationships, how people treat and mistreat me. Whether I’m included or excluded in activities and spaces – am I invited to the stag or stagette? It’s about my assumed preferences on beverages (wine or beer?), books (YA romances or SF alien porn?), movies (action or chick flicks). It’s about whether I’m expected to feel one way or the other about comedy, music, personal hygiene, hobbies. It’s about the instrument I’m assigned in band class (baritone, because flutes are girly), the birthday presents I receive, the clothes I’m expected to wear. It’s not all about the clothes, though god, it really is all about the clothes.

I do, of course, have dysphoria about my body. Else I wouldn’t be sitting on this couch talking to this psychiatrist, hoping he can unlock the doors of his mind and accept the idea that people without sight are not people without experience.

I am indeed fortunate that my dysphoria isn’t triggered by seeing other women, but it is triggered by lots of other things, like hearing about periods, hugging them and feeling a chest that isn’t flat as a pancake, bumping into hips that aren’t cursed by narrowness, and knowing that those lucky bitches do not have to contend with the cursed crotch bulge.

So yes, on some level, my dysphoria is triggered by intellectual knowledge and not by visual reminders, but unlike certain cisgender dudes with doctorates, I actually use all of my senses around people, and even, on occasion, my brain. In fact, for me, one of the most dysphoric things in my life is my voice.

The Point of it All

The point, thanks for asking, is that whether we’re blind or sighted, our senses of self are bound up in our gender. I’m not sure about everyone else, but I don’t need functional eyeballs to tell me when there’s something out of whack with my sense of self.

But I’m just an anxious, blind transgender lady with two post-secondary degrees and a shit ton of lived experience.

What do I know?