As states move to restrict or ban access to gender-affirming care, a moral panic about trans people envelops the public sphere, and youth and adults find themselves in an urgent and potentially life-threatening situation. This restriction of care for youth, and sometimes adults, is whipped up by assessments that transness is infectious, and that the state, insurance companies, doctors, and medical professional organizations have everything to gain in following current standards of trans medical care. Although these standards have a complex history and do not yet include optimal standards of informed consent and transformed concepts of body and gender, they are urgently needed. Accompanying these restrictions are attempts to legislate trans people out of existence and threats to remove trans and gender non-conforming people from social life. Living in this interregnum is proving to be an intimidating and exhausting task.
Alongside important arguments that civil rights, First Amendment rights, and freedom are violated by this legislation, we should examine how trans and gender non-conforming people are deprived of their needs. What does a shift from the language of “rights” to “needs” contribute? For one, some argue that basic human needs are the foundation of rights. If that’s correct, then thinking about needs gets us closer to the root of the moral wrong that trans people and their allies are identifying. Moreover, the trans-antagonistic arguments in legislation and public discourse contain implicit and explicit premises about what needs are, and whose needs matter. Bills that ban gender-affirming healthcare rely on thick metaphysical claims about what is healthy and what constitutes proper and improper modifications to one’s body, where human needs map onto the ‘normal’ (cis) development of male and female biological sex, nestled in broader arguments appealing to the human need for reproduction. In addition to obscuring numerous facts about the actual conditions of trans healthcare today, these bills ignore basic facts about how healthcare involves meeting needs in a person-specific way utilizing age-appropriate measures of informed consent.
Further, using needs language to make political arguments capitalizes on the distinct moral power of needs rhetoric. When someone makes a claim of need, and a witness or addressee determines the claim to be legitimate, that person seems to have a defeasible obligation to help meet the need. A lot of moral argumentation happens in the background and lies in our intuitions, such that ‘Lise needs water’ likely calls to mind an image of a thirsty person as opposed to, say, a person looking to boil pasta. We are already immersed in the rhetoric of basic needs—goods such as water, shelter, nourishment, healthcare, and basic safety—through global development and welfare state programs. Thus, there lies the fruitful possibility of articulating trans claims of need in relation to this background moral context.
However, trans needs seem to exceed the dominant way we conceptualize needs. The concept of need we inherit through basic needs discourses is connected to survival of the human organism and regular social functioning. The medical and social goods that facilitate gender transitions are required not simply for the bare survival of trans people, but also for something closer to personal actualization or creativity. They imply a richer concept of necessity.
Considering trans needs claims illuminates a development in the conception of need: mere survival does not explain the moral claim of needs. Philosophers have more recently endorsed agency-based accounts of the normativity of need. On these views, we are dependent on each other to become and remain agents, and agency needs are those morally forceful needs that demand response and may generate obligations. We need nutrition and housing, but also bodily autonomy, healthy relationships, and some degree of social recognition to be agents. Staying within the resources of agency-based accounts, we can make the case that easy gender marker changes, gender-affirming care, bathroom access, and proper address all constitute (trans) needs because one’s agency is stunted if one is denied the measures to take up and hold agency. Since, in this society, being an agent requires being a gendered subject, gender needs are simply agency needs.
Let’s go over the agency-based approach to needs. It’s intuitively plausible that needs make a claim on us because they enable the development of human agency. On this conception, the needs of gender transition are not a unique class of needs, but rather an expression of agency needs that all human agents have. From the fact that we all depend on each other to be and become agents we can draw an important reason to meet others’ agency needs when we are best positioned.
The agency-based approach, however, doesn’t quite fit the picture of trans needs. Consider binders, makeup, the perfect blouse, a tailored shirt, everything it might take to be beautiful—these are not luxuries. Nor are they needs in the agency sense, for achieving beauty or one’s aesthetic vision is not essential to being an agent.
A crucial element of resisting gender binariness and cis-normativity is an expanded sense of what is necessary. This includes fighting for trans beauty, protecting the need to be beautiful. Alok Vaid-Menon explains that for queer, trans, and racialized people, self-expression is a creative need that is structurally denied by micro and macro operations of power: “I did not know anyone who looked like me, or who felt or thought like me, so I was made to be like the leftovers of other people’s beauty making: In order for them to be beautiful, I had to not be.” Under these conditions, to pursue beauty is not a luxury. It is a radical need—radical in the sense that Marx describes: it aims at human flourishing with the understanding that human activity is both the ‘problem’ and ‘solution.’ As a radical need, it is a necessity that is persistent, ineradicable, cannot be satisfied in this society, and points towards a social organization to come. Creative self-expression is a radical need made explicit by trans subjectivity. This need also conveys the more expansive need for a new aesthetic common sense, a new set of morally perspicacious facts, the embrace of fluidity in social roles, and the transvaluation of values.
Should we rest with the agency-based approach, we suggest that trans needs can be met by the institutions and practices of existing society, when in fact they cannot. Consequently, the revolutionary character of trans needs is missed. Consider, for example, the entwinement of trans needs and material justice. Formal and informal laws and mores that specify socially acceptable (gender) presentation and behavior have always concerned who has legal access to the means of survival and goods of building a life. As Jules Gill-Peterson helpfully explains, anti-drag laws and other measures to restrict the public presence of trans people belong to a lineage of anti-crossdressing laws and other measures of anti-vice campaigns aimed at public order and decency. In this context, laws to restrict the public presence of trans people should be understood to bear most greatly on racialized and poor people, who are targets of policing. From the 19th century to now, enforcing cis-normativity has supported securing the hegemony of private property and white patriarchy. Through this genealogy, it is appropriate to claim that gender is policed. This policing threatens the satisfaction of democratic and justice needs for public presence, political standing, and equal participation in the shaping of the future of the nation. It also threatens how gender nonconforming people can satisfy social needs to sell their labor legitimately and take up cultural space.
These justice needs and social needs do not simply aim at agency; they aim at a new society and imply a transformation of the background moral context. To return to the question of whether trans needs are simply needs for agency, it seems the answer is no. Although agency may be a value affirmed by transitions, it is not obvious that agency is the orienting or sole good of transitions or trans justice. In the picture of need just presented, there are many explanations and justifications for why needs merit response. Hormone therapy may be necessary to ensure trans survival. In atmospheres of violence, it may take mutual aid and community support organizing to combat suffering. In corporate workplaces and classrooms, taking care to address people as they want enables their fair participation. Creating venues for queer performance satisfies individual and community creative needs.
As we pursue a needs-based analysis of (trans) politics, we ought to take a non-ideal and pluralist approach to need that begins from the fact of oppression and assumes that part of what is up for debate in needs-disputes are thick assumptions about the good life. This is a political approach, in that a vision of a society where trans people are not viewed as deviations from the aesthetic norm, for example, is required to critique the current ways of determining needs and identifying the needy. This vision manifests an expression of the contemporary politics of need.
The politics of need is personal and reveals the dynamism of our own needs. The point of an accompanying ethics of need is not primarily to distinguish needs from wants or other less morally important claims. It is to defend the conditions for innovating our own needs. We do not simply have needs. We work on our own needs as we self-explore and innovate, struggle to reduce our suffering, and work to maximize our freedom. Transitioning and de-transitioning is but one example of the human activity of developing our own needs. While it has been intuitive to see the moral importance of meeting survival needs, the present moment contains the potential to bring to light the legitimacy of greater agency and creativity in the development and satisfaction of our needs. This can only come to fruition with wide systemic change that bears on both material and symbolic realities. Meeting trans needs has the potential to be world-transforming.
Jules Wong
Jules Wong is a Graduate Fellow at Penn State University and a SSHRC Doctoral Fellowship holder beginning Fall 2023. They research the ethics and politics of need with a focus on gender.
Excellent and important post. I wonder if part of the barrier is that both rights-based and agency-based approaches seem biased toward individualistic or liberal politics. Instead of specifying the abstract needs of arbitrary individuals, it seems like we need a more context-sensitive approach that takes the substantive values of particular groups into consideration. I thought your piece pointed us in this direction.