Written by Margaret Wetzel

An autistic teenager struggling to fit in believed that going on estrogen would resolve his communication difficulties (de Vries et al., 2010). A girl thought she would have more friends and more affection from her parents if she was a boy (Evans & Evans, 2021). In a documentary called I Want My Sex Back, a trans-identified male named Rene Jax stated:

The main milestone was finding a doctor who would give me the hormones. If I get… female cross-sex hormones my life will be perfect. And then you think, “Well, if I can only get my voice – get my male voice up here – then that’ll make me, you know, just happy.” And then you think, “The next thing is, well if I can get breast implants that’s all I need.” It’s never enough. And finally, if you’ve gone through the therapy and you can convince a doctor to start cutting on you, you go and you have a sex change (Vorobey, 2018).

In all of these stories, the trans-identified people came to believe that by pursuing hormones and surgeries, they will reach their idealized lives. However, while hormones and surgeries will directly impact people’s appearances, they can’t teach people how to communicate, they can’t secure loving parents, they don’t guarantee healthy friendships, and delivering a sustainable sense of perfection is not possible. Therefore, people seeking these surgeries and hormones have put meaning into these events and activities, even though that meaning cannot be achieved through them. 

Canadian anthropologist Grant McCracken (1988) used a concept called “displaced meaning” to explore the consumer behaviors of Americans. When people notice a gap between their current and idealized lives, confronting the gap directly would lead to undesirable emotions. To maintain a belief that the idealized life is achievable, people will place symbolic meaning in items available for purchase and treat these items as a bridge between the real and the ideal.

Imagine a single man who longs for a calm life and a loving wife. When he sees an advertisement for a rose-covered cottage, he imagines that purchasing it would unlock a sense of calmness and fit with his idealized lifestyle. In his mind, the cottage will provide a way to access his idealized life. He saves up and purchases the cottage. Only he isn’t any calmer. A wife didn’t magically appear. The symbolic meaning he placed into the cottage wasn’t really there – it was displaced meaning. Once again confronted with the gap after obtaining proof that the cottage wasn’t a bridge, he finds a new location for displaced meaning – perhaps installing a firepit surrounded by string lights will lead to sustainable satisfaction.

To be clear, not all purchases are connected to displaced meaning. Had the man purchased a home so he’d have a roof over his head, this wouldn’t be displaced meaning as a house would directly provide this – it’s only displaced meaning when the item purchased is seen as a symbol for an idealized life it’s unlikely to directly provide.

Given the way some trans-identified people discuss hormones and surgeries as a ticket to their idealized lives in ways that extend beyond the direct cosmetic changes, it seems likely that displaced meaning is motivating some people to “transition.” If this is the case, we have cause for serious concern – displaced meaning is not accessed when the items, such as surgeries or hormone treatments, are purchased. This is because the meaning was never there to begin with; it was imagined. Furthermore, hormone treatments, whether they are puberty-blocking or cross-sex, have some hefty side effects, and risk-free surgeries don’t exist. Undergoing these types of treatments to try to achieve something that cannot actually be found seems awful.

Worse yet, when the meaning isn’t reached, this creates a need to continually displace the meaning elsewhere. The quote from Rene Jax shows his progression from first desiring hormones, then voice coaching and breast implants, and finally, even a vaginoplasty. When none of the earlier steps in his “transition” brought him the life he wanted, he just kept going further down a medical path, believing the next step would finally be the one. Yet, even after a vaginoplasty, the meaning he sought was not reached:

I had my sex change in 1990 and in the back of my mind I didn’t think… I thought it might be like all the other stuff I had done, but I was hoping, just hoping that that would make me feel complete. [...] The sex change didn’t solve my discomfort. The doctors who are honest will say that the gender dysphoria is always there and it’s because the confusion… starts out being about your anatomy, but really… it’s you don’t like yourself (Vorobey, 2018). 

This situation of displaced meaning is not unique to trans-identified males. In Erin Brewer and Maria Keffler’s Transing Our Children, a female detransitioner’s story is shared:

After doing everything she could conceive of, from hormones to mastectomy, to a hysterectomy, she finally realized that transing didn’t help. This was a troubling realization: “And so I was just like, wow, okay, that’s it.  This is the end of the road.  That was the last surgery I was going to get.  So what do I do if I’m not getting another surgery?  There’s nothing to look forward to” (2021, 116). 

Pursuing displaced meaning down the “transitioning” tunnel isn’t a safe bet for people – the side effects from the hormones and surgeries add up. Furthermore, the time spent “transitioning” could have been used by people to build a better life in a way likely to create the meaning that they were seeking. 

Perhaps the darkest part of this issue is when the end of the tunnel is reached. Without any more treatments to displace meaning into, the gap between the real and the ideal will be confronted head-on without an easy escape. As Brewer and Keffler (2021) noted, “Once she realized that transing wasn’t the answer to her difficult feelings, she said, “The depression hit me really hard. And I was like, I’m still not happy. I’m still not happy after all of this.””

This mental crash was also observed by trans-identified male Blaire White (2019). We can see displaced meaning in the situation he describes:  

So after people have that surgery [vaginoplasty], it’s actually very common for them to have a very very deep depression, one that leads them to doing things that are obviously unspeakable [...] So then I think to myself, okay then maybe the truth is that a lot of trans people see “the surgery,’” “the big one,” “the big snip” as sort of like a fix to their life.  They make it the biggest goal in their life like they have this incredible build-up to it that they’re waiting their whole lives for it and then when they get it they realize “Oh, rent is still due, I’m still dealing with this bad relationship, I still have these issues with my family, I still don’t have a career going for myself.”  I think that people put so much emphasis on it as if it’s going to fix their life when in reality it’s not going to. 

“Gender-affirming care” has become the main protocol promoted by many healthcare agencies, and displaced meaning is not a commonly discussed concept. Very little guidance has been provided about how to help people who want to “transition” due to displaced meaning. Perhaps the best guide for people seeking more information would be Evans & Evans’s (2021) Gender Dysphoria. In this resource, the two therapists model how practitioners can help “gender dysphoric” patients sort through their underlying motives behind transitioning. As the patients’ underlying motives are revealed, the patients can better understand if “transitioning” is actually necessary to obtain what they desire. In cases of displaced meaning (or “phantasies” as Evans & Evans describe the concept), the clients can begin to see that they do not need to “transition” to build a robust life. The clients can also come to understand that “transitioning” will not solve life’s problems. Research indicates that people with autism struggle with symbolic thinking and favor solutions that appear concrete. Therefore, this demographic group may benefit even more from exploring displaced meaning before “transitioning” is considered (Wetzel, 2022). 

We need a future in which people who are struggling with accepting their sexes are encouraged to explore the deeper reasons for their struggles, including why they think hormone treatments and surgeries will help them achieve intangible results like happiness. Such a future could lead to better-informed treatments for people who are questioning their identities, and create a more realistic picture for them of what will happen when they “transition.” Such a future could also help these individuals improve their mental health, avoiding the slippery slope of constantly moving down a medical pathway that causes irreparable changes to their bodies. 

Works Cited

Blaire White. (2019). Why I’m not getting ‘the surgery.’ [A video]. YouTube. https://www.youtube.com/watch?v=z1ZWX5r_0MI. 

Brewer, E., & Keffler, M. (2021b). Transing our children. Partners for Ethical Care.

de Vries, A. L., Noens, I. L., Cohen-Kettenis, P. T., van Berckelaer-Onnes, I. A., & Doreleijers, T. A. (2010). Autism spectrum disorders in gender dysphoric children and adolescents. Journal of autism and developmental disorders, 40(8), 930–936. https://doi.org/10.1007/s10803-010-0935-9.

Evans, S., & Evans, M. (2021) Gender dysphoria: A therapeutic model for working with children, adolescents and young adults. Phoenix Publishing House.

McCracken, G. D. (1988). Culture and consumption: New approaches to the symbolic character of consumer goods and activities. Indiana University Press.

Vorobey, A. (2018). I want my sex back: Transgender people who regretted changing sex (RT Documentary). [A video]. YouTube. https://www.youtube.com/watch?v=eva-dgwiP40. 

Wetzel, M. J. (2022). Picking Up the Pieces: Puzzling Through Autism in the wake of “Gender.” Kindle Direct Publishing.