Trans Medicine: The Emergence and Practice of Treating Gender

by stef m. shuster

Overview

**Finalist, PROSE Award in Clinical Medicine**

A rich examination of the history of trans medicine and current day practice

Surfacing in the mid-twentieth century, yet shrouded in social stigma, transgender medicine is now a rapidly growing medical field. In Trans Medicine, stef shuster makes an important intervention in how we understand the development of this field and how it is being used to “treat” gender identity today.

Drawing on interviews with medical providers as well as ethnographic and archival research, shuster examines how health professionals approach patients who seek gender-affirming care. From genital reconstructions to hormone injections, the practice of trans medicine charts new medical ground, compelling medical professionals to plan treatments without widescale clinical trials to back them up. Relying on cultural norms and gut instincts to inform their treatment plans, shuster shows how medical providers’ lack of clinical experience and scientific research undermines their ability to interact with patients, craft treatment plans, and make medical decisions. This situation defies how providers are trained to work with patients and creates uncertainty. As providers navigate the developing knowledge surrounding the medical care of trans folk, Trans Medicine offers a rare opportunity to understand how providers make decisions while facing challenges to their expertise and, in the process, have acquired authority not only over clinical outcomes, but over gender itself.

Product Details

ISBN-13:	9781479899371
Publisher:	New York University Press
Publication date:	06/15/2021
Pages:	240
Sales rank:	998,609
Product dimensions:	6.00(w) x 9.00(h) x (d)

About the Author

stef m. shuster is Assistant Professor of Sociology at Michigan State University. Their work on transgender healthcare has appeared in Gender & Society, Journal of Health and Social Behavior, and Social Science & Medicine.

Table of Contents

Glossary vii

Preface ix

Introduction 1

Part I Historical Contexts of Trans Medicine, 1950S-1970S

1 Creating Worthy Patients, 1950-1970 23

2 Legitimacy Wars between Physicians and Therapists 49

Part II Contemporary Trans Medicine

3 Making It Up: Evidence in Contemporary Trans Medicine 77

4 Medical Uncertainty: Working with Trans Patients 101

5 Uncertain Expertise in Trans Medicine 129

Conclusion: Rethinking the Treatment of Gender 155

Acknowledgments 169

Appendix: The Strength of Multi-Sited Studies 175

Notes 185

References 201

Index 213

About the Author 223

Editorial Reviews

"Sociologist Stef M. Shuster’s Trans Medicine is a unique monograph that combines historical analysis with ethnography."

Bulletin of the History of Medicine

"Overall, shuster’s book is an engaging exploration of the histories of trans medicine with an emphasis on health care administration and politics…Trans Medicine holds immense value for medical school and continuing education programs and would promote fruitful dialog about inclusive, accountable, and just health care practices."

Medical Anthropology Quarterly

"Trans Medicine is remarkable for the way in which shuster captures health care providers speaking and acting with exceptional candor about what they think and feel about working with trans populations."

Danya Lagos - Universityof Californian Journal of Sociology

"Trans Medicine is remarkable for the way in which shuster captures health care providers speaking and acting with exceptional candor about what they think and feel about working with trans populations."

American Journal of Sociology - Danya Lagos - University of California

"A powerful examination of the history and present of medical providers seeking to 'treat gender.' Demonstrating how uncertainty unsettles the relationship between expertise, evidence, and clinical decision-making, Trans Medicine illuminates the path to a more inclusive, gender-affirming health care system."

Rene Almeling

06/01/2021

Noting trends in evidence-based medicine (EBM), shuster (sociology, Michigan State Univ.) situates the emergence, from the mid-20th century to the present, of a field of medicine dedicated to caring for transgender people. The author uses archival sources from the Kinsey Institute, interviews, and ethnographic techniques to construct their wide-ranging narrative. Questions they consider include: Who decides which patients receive care? Who had the ultimate authority to determine protocols in the nascent field of trans medicine: physicians or therapists? These important questions have been debated for decades, and shuster (who writes their name all in lowercase) expertly documents how the medical field has often failed trans patients. This book discusses the way EBM has increased the scientific legitimacy of trans medicine, though not without the risk of making it a specialty and further othering the field. This book successfully makes the case that trans medicine should be part of the medical training of all physicians. Though shuster is trained as a sociologist, their work has a broad audience among academics, especially in the history of science and medicine. VERDICT This well-researched book is eminently readable and, in fact, quite a page-turner. It is an essential story, one that is not yet complete, as shuster acknowledges. A must-read.—David Azzolina, Univ. of Pennsylvania Libs., Philadelphia

Library Journal

"Trans Medicine is a brilliant study of how the context of scientific uncertainty shapes the ways medical professionals work with trans people. While appreciating the dilemmas facing doctors, shuster holds them accountable for upholding normative understandings of gender essentialism. This beautifully rendered story of medical improvisation and the search for professional credibility will be of great interest to readers of transgender studies, medical sociology, and the sociology of knowledge."

Arlene Stein

"Trans Medicine is remarkable for the way in which shuster captures health care providers speaking and acting with exceptional candor about what they think and feel about working with trans populations."

Danya Lagos - University of Californian Journal of Sociology

"Trans Medicine is original, empirically rich, and beautifully written. shuster masterfully integrates a wide range of data with a nuanced theoretical story of power, control, and medical regulation. This is truly an urgently needed study that is a must-read for anyone interested in the intersection of gender, sexuality, bodies and embodiment, and healthcare."

Georgiann Davis

"Trans Medicine is remarkable for the way in which shuster captures health care providers speaking and acting with exceptional candor about what they think and feel about working with trans populations."

American Journal of Sociology - Danya Lagos - Universityof California