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Forskaren Tristan McKenzie står på en klippa med havet som bakgrund

Hi Tristan, tell us about yourself!
Hi! My name is Tristan McKenzie and I am an American living in Sweden. I currently work as a postdoctoral researcher in the Department of Marine Sciences at the University of Gothenburg. I am also a transgender man.


What does it mean to be trans?
At the most basic level, being transgender means the sex you were assigned at birth differs from how you identify. This is different from cisgender people, who have a gender identity that is consistent with their sex assigned at birth.

For most trans* people (I use the * to signify inclusivity of the gender spectrum), the disparity between sex assigned at birth and gender identity relates to how one feels in on the inside, dysphoria around primary and secondary sex characteristics, and social perceptions of their gender. It is fundamentally a biological/medical issue, and I think one of the ways the range of the human experience can be beautiful.

It is important to differentiate gender identity, sexuality, and gender expression, as these are not the same. I like this concept of the “Genderbread Person” – trans people can have a range of sexualities (just like cis people) and differs from gender expression (for instance, just because someone enjoys crossdressing, doesn’t mean they are transgender).

I also want to point out that sex is also a spectrum – intersex people represent 1-2% of the population. Most intersex people are not transgender, but I bring this up to demonstrate that there are more options than the female/male binary that society forces us into. Many cultures throughout human history have recognized and celebrated a third gender (māhū, hijra, etc.). So this idea that gender (and sex) is a spectrum isn’t a new concept, it’s something that’s always been here.


What challenges do trans people face?
Trans people face many challenges, including discrimination, harassment, violence, abuse, and ostracization from family and friends. These issues, which largely stem from lack of understanding, can lead to limited medical support, financial struggles, and poor mental health.

There is a reason that over 40% of trans people have attempted suicide – it’s not intrinsic to being trans, rather it reflects the challenges associated with receiving both medical and social support. Access to gender affirming care and good social support has been shown to drastically improve mental health outcomes for trans people. This goes back my point previously – being trans should be solely a medical issue, not a political one.


What challenges do trans people face that are specific to Sweden? How does that differ from your experiences in the US?
The challenges that trans people face certainly have some commonalities, regardless of location. To me, the biggest challenge facing trans people in Sweden is access to trans healthcare and ease of changing legal documentation.

I am American and started my transition prior to moving to Sweden. Thus, I’ve had an easier time with the Swedish system for trans healthcare, but I have the perspective of living in multiple countries as a trans person (including the US, Canada, and Australia). In my opinion, the Swedish approach to trans healthcare is antiquated and harmful.

In Sweden, it is required to get “diagnosed as transgender” prior to receiving medical treatment or changing one’s gender marker. This is region dependent, but waitlists to even begin this process are typically more than 2 years (Vårdgaranti does not apply here).

Once your time comes, you go through the “Investigation” process at a gender clinic, consisting of a psychologist assessment of your gender identity and overall mental health – this can take another 2 years. Assuming the medical team decides you’re trans (which I’ve heard largely excludes nonbinary people), then you’re finally referred to the waitlists for medical transition (hormones, surgeries, etc.).

This idea of having to prove you’re trans to a mental health professional over a multi-year process of invasive questioning, is completely insane to me. I do think there is value in seeking therapy to explore one’s thoughts about their gender identity and life changes during transition, but that should be separate.

There is a lot I love about Sweden, but this patronizing approach to trans healthcare is not one of them. I believe a lot of this is driven by cisgender people questioning why anyone would want to transition and the myth that many trans people “detransition”.

However, fewer than 1% of people regret medical transition, yet over 7% of people regret having children in the US and Germany, and a 14% regret rate amongst all types of surgery. What other medical intervention has such a high satisfaction rate?! But again, this comes down to a cultural issue and general misunderstanding of trans people.


Do you think Swedes in general know how complicated the process is, or how discriminatory health care can be? 
My impression has been that most Swedes think that trans healthcare is easy and quick to access, and that Sweden has a progressive approach to trans issues, but in my opinion, that is far from the truth.

Until 2013, trans people in Sweden were forced to be sterilized to pursue gender affirming surgeries or change their gender marker. Even now, one cannot change their gender marker without the diagnosis that takes many years to get (there is legislation in the works to change this).

While some of this will arguably change and reflects slow policy updates, some things are actively going backwards. For instance, despite the substantial evidence demonstrating major positive effects for trans youth undergoing some form of medical transition, trans healthcare is pretty much unavailable for those under 18 (February 2022 Socialstyrelsen update reducing access to care for trans youth in Swedish and English). Yikes.

On the flip side, I have found Sweden otherwise great as a trans person in terms of safety and societal acceptance (relative to the US at least). But there is still a lot that can be improved.


How do you think your personal experience as transgender person might be different to other members in the community (race, social status, social class)?
I am white, highly educated, have a good job, a great support network, and as a trans man, I benefit from male privilege to some degree. I have an easier time in society and generally have the advantage of stability and safety for those reasons. My experiences likely vastly differ from, for instance, trans women, people of color, people who have unsupportive families, asylum seekers, or those without employment (even in Sweden).


What would you like to share with the world? What is the most important thing society should know about transgender people?
We are just normal people, trying to exist in the world, same as everyone else. I would encourage cisgender people to learn more about trans experiences and struggles, and areas where cis people have privileges that trans people frequently do not.

Unfortunately, the loudest people in the room are also the ones that are afraid of us. We need your help changing the narrative.


Läs mer? 
Vill du läsa mer om Tristan och hur det är att leva som transperson, kika in på denna blogg

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