Did you get a genetic test to see if you're intersex?
I get the question once every few months, usually from a well-meaning and honestly curious person. It's an interesting question, as well as a bit of a hot-button issue within the transgender community. I mean, who wouldn't want to know if there was a genetic reason for their transgender feelings, right? Being intersexed is no big deal, after all, and is just another part of the tapestry we call gender. Getting tested wouldn't do anything to affect my status as a woman.
However, I take a different tack when answering this question, mostly because I sometimes doubt the reason behind it. This innocent question carries with it the idea that transgender identities must be pathologized, categorized, and explained in scientific terms. Since most transgender people are by necessity self-diagnosed, there is always a shadow of doubt cast upon the process. "Are they really transgender, or are they lying to themselves?" The question never really goes away, and people are always seeking an answer that falls within their own prejudices.
Thus, I find the best way to tackle it is to frame the answer within the words usually featured alongside it: "I hope it will never be something you regret doing."
Trans people have an uphill battle on pretty much every front. If it's not discrimination, family issues, acceptance in society, or simply just not being beat up, killed, or otherwise hurt because of who they are, they must also battle the medical community that's sworn to serve them. Despite the fact that the APA and AMA both accept the diagnosis of Gender Identity Disorder, and despite their recommendation that transition is often deemed medically necessary, our diagnosis is almost always cast in a shade of doubt.
The thought that occurs both in the minds of professionals and casual observers remains, "Well, sooner or later they could live to regret it," and that is oftentimes enough to deny care to transsexuals. For example, there are exactly two doctors in Indianapolis who deal with transgender patients' needs, and both are difficult to find without knowing somebody who knows somebody. A quick search for "Rhinoplasty," in contrast, returns 58 results. While this certainly not a fair comparison, it does paint in broad strokes just how little attention the mainstream medical community pays to the needs of people like me.
More appropriate for our situation would be scoliosis, which serves as a perfect counterexample of how the medical community usually treats maladies. Everyone is checked for the disease, as it can cause disfigurement, paralysis, and in extreme cases death. When a case is discovered, experts immediately work to fix the problem, and the treatments are covered by insurance. Scoliosis falls into the regular medical model: we can clearly see the problem, we can clearly see the results of non-action, and can determine that action will have a net positive effect.
The only difference between scoliosis and gender identity disorder is that we cannot clearly observe the symptoms. People with GID bear no external markings, no identifiers, and no symptoms beyond what is going on between their ears. Medical professionals have devised tests that control for misdiagnoses such as schizophrenia or borderline personality disorder, but for the most part GID is a self-diagnosed issue. Despite not having noticeable symptoms GID brings with it tangible consequences for non-action: depression, self-image issues, suicide. Two in three transgender people attempt suicide. One in three succeeds. We can see the results of non-action, and we can see that action will have a net positive effect, but the symptoms escape us.
This lack of tangible symptoms throws the whole medical model into a tizzy. Trans people are often required, either by social pressure or by the medical community, to go to extreme lengths to prove their diagnosis. For example, I saw four different therapists before I found one willing to talk about my gender issues seriously; the first three dismissed my problem as transvestitic fetishism without even considering GID, and the fourth denied my diagnosis because I "didn't express enough feminine traits as a child." And even when I did finally get my diagnosis, and my hormones, and permission from the government to change the identifier on my license, the shadow of doubt is still cast over my identity as a woman. "She may still regret being a she," the logic goes. "Sometime, somehow."
Thus, people reach for a surefire diagnosing tool, even though no such tool exists. Genetic testing combines the scientific finality of chromosomes with the reverence of concrete diagnoses: it seems that it's easier for people to "get it" if they know that the transgender person is between genders chromosomally.
I feel that these genetic tests further aid the pathologization of GID in our society. The unspoken assumption of these genetic tests is actually moderately sinister: "If she's actually intersexed, or if she's chromosomally female, that explains everything and makes it better." I've seen it with a few other trans women deal with this issue, and I worry about the unforeseen consequences of putting up an intersex identity as an excuse for being transgender.
Would being intersexed somehow make me more of a woman, or explain that something really was wrong me to begin with? I don't think so. I'm transgender: I know this because my brain tells me that I am. An intersexed diagnosis would change nothing. Part of being trans is learning to have the resolve necessary to say, "This is who I am, and that's that." I've had to battle my family, my friends, my therapists, and my doctors to get this process rolling, and in the end most everyone has agreed that it has made me happier. Yet there is always a doubt in people's mind, and on occasion people do step up and express it. I get the feeling that if I could respond with "Well, I'm actually not a genetic male" that these fears would mostly be allayed, but what good would that do me? I'd still be transgender, one way or another, in the eyes of society.
I don't feel that I need to pathologize or rationalize my gender issue via a genetic test for it to actually exist. I fought depression and dysphoria with my body for most of my life and eventually worked up the courage to face it. When I started hormone therapy, the depression was mostly solved, leaving me free to feel like myself for the first time in my life. As far as I'm concerned, this alone proves the fact that I'm a transgender woman, and this is the right decision.
I will eventually have a genetic test - it is the future of medicine. However, I will not be typed for sake of discovering the status of my sex chromosomes. I don't need a scientist to tell me I'm a woman, just like the questioner doesn't need a genetic test to know their gender.