Sometimes this is expressed in a more more subtle manner: concern-trolling about poor lesbians and/or masculine girls who might get confused and transition, people who are anti- certain body modifications comparing medical transition to those body mods, or even throwing out a comment about how trans-related surgeries don't look/function well.
Sometimes, they are very, very obvious: talking about chopped up or mutilated bodies, outright saying that ev0l doctors and trans* people are coercing lesbians/butches into transitioning, that we're just delusional freaks, or that trans* people are like anorexic folks and medical transition is like liposuction or gastric bypass surgery.
First of all, compare a transphobe's thoughts on how being trans* is self-harm to a homophobe's view that being queer is self-harm.
There really won't be too many differences.
Usually the transphobe will say something about how patriarchy/Satan/etc causes trans* people to Not Be Good Cis* people or how in a more godly/feminist/etc world there would be less of us. Replace trans* with queer and cis* with straight and you have a homophobe's thoughts.
Compare “transitioning is harmful and it's wrong to remove healthy tissue!” to a homophobe's thoughts on how queer sex is Dangerous and Bad For You.
They sound the same and they are both just as wrong.
If you believe the notion that being trans* is self harm that means you believe there is something wrong with being trans*; that it is right and natural to be cis*.
It follows that you believe it is better to stop trans* people from being trans* (or, openly being trans*) than it is to remove transphobia and cissexism.
Because, in this view, transphobia and cissexism are good, right, normal, and natural; after all, if we didn't mess up your perfect world we wouldn't get hurt.
Sure, you'll say that they don't want people to be hurt, but then...as long as we just shut up you don't ever have to think about it, now do you?
Or, as Cedar says, “Society’s myth of universal cissexuality *is* incredibly fragile, and has to be protected at all times–but what has to be done is not to create a stronger foundation (which they never ever do) but to disrupt any other conversation that’s happening.”
Yes, being trans* can be difficult.Yes, there are a lot of dangers out there for trans* people.
But, removing transphobia and cissexism will remove most of those difficulties and dangers; really, the only ones intrinsic to being trans* are body dissonance, gender disphoria, and things like depression that result from denial and such.
Medical transition usually removes the body dissonance. Living as your actual gender, without discrimination and harassment, will take care of the issues caused by pretending to be the wrong gender; having your loved ones and social circle gender you correctly will as well. Therapy will take care of whatever that doesn't; talking through issues that childhood denial caused (and childhood denial should happen less often in a world without transphobia), therapy or anti-depressants should help with depression, etc.
So, since in a world without transphobia there would be few, if any, major difficulties or dangers to being trans*, being trans* is really not all that intrinsically harmful--it's the cis* world's cissexism and transphobia that are the problems.
I suppose to someone out there in the world there is some knee-jerk validity to the idea that you shouldn't perform surgery on healthy tissue...
But, you have to look at what you are considering healthy tissue and on how you are defining words like harm, needed, unnecessary, etc.
Is tissue that you feel, deeply and instinctively, to not even belong to you really all that healthy?
Is psychological pain not considered harm?
Should a person have to attempt all sorts of therapy and mental gymnastics to accept how their body is currently shaped instead of having surgery or hormones?
Is the former not as harmful as the latter?
Is removing psychological distress unnecessary?
Do you think that people can just ”get over it”, “cheer themselves up”, or ignore anything that isn't purely physical?
Well?
Well, I would say, that is someone needs to medically transition then whatever hormones or surgery they have are needed and necessary.
(personally, I do not have issues with body mods or other “unnecessary” surgeries, so if a trans* person who doesn't need to medically transition wants to, I have no issues with that. But I think that may be a little off-topic, I just wanted to make that clear...)
Sometimes you get people, sometimes well meaning but sometimes mean spirited, bringing up the actual or supposed limitations of medical transition: “Why would you want to have a penis that doesn't function?” “Aren't you afraid of looking like a freak?” “Wouldn't you rather keep your body how it is than worry about what sort of health complications transition could bring?” “But you're such a pretty girl?”
First of all, what is functional, working, pretty, etc is defined by the individual. Like how you hear a lot of static about how ugly and nonfunctional phalloplasty is, yet every guy I've heard from who actually had it loves the results.
Honestly, I don't see anything “freakish” about trans* people's bodies. Our bodies, no matter what medical treatments we have or have not chosen to have, are not freakish or ugly or disgusting. A lot of people have scars. A lot of people have had invasive surgeries to improve their quality of life; there is nothing disgusting or ugly about it.
Everyone has different preferences for facial features and the like; some people find “feminine” looking men (trans* and cis*) attractive, some people find “masculine” looking women (again, trans* and cis*) attractive. We will be attractive to some people out there; moreover, attractiveness is not the be and end all of happiness.
We also weigh the health consequences carefully. Yeah, when we choose to take hormones or have surgeries we gain a greater likelihood of some complications, but there are usually complications to not having those procedures as well.
Remember, how are you defining healthy? I'd say not-suicidal yet at a greater risk of heart problems is a hell of a lot healthier than being so depressed you can't take care of yourself and constantly try to kill yourself.
It's not like we jump into medical transition without thinking.
For instance, I've seen a few trans* guys who've had to come to terms with their beliefs about what constitutes healthy tissue and unneeded medical procedures and their need for surgery. Some suggested that trans* folks wrestling with these feelings think through it like I did above. Others said that they had had a dialogue with their body; telling their chest or uterus how while there may not be anything wrong with them, they simply didn't belong on their body, how much they needed this surgery, etc.
I don't think there is anything wrong with the trans*folks that had/have these feelings; we live in an ableist and transphobic world after all. But I do think we should examine these feelings and decide what are our ethical beliefs and what is just internalized shit.
There's also this idea that “1950's psychologists" invented trans*ism as a way to make queer and gender-nonconforming folks into straight conforming folks. Check out any decent history on trans*ism or trans* people, The History of How Sex Changed, Transgender History, etc, and that trope will be proven wrong.
Trans* people would comb through science/medical journals, write to the few drag/trans* newsletters, write to Christine Jorgenson, etc. begging for information on how to transition and who to go to. Women would take BC pills and other forms of estrogen and then go to doctors and say they were intersex. Even now we still have to work to get any help medically transitioning at all.
And ya know, we really don't seek out questioning people to convert to our Dangerous Lifestyle; our communities constantly have trans* people just coming out of denial coming to us asking for information and help.
Whenever I've seen people ask for help in figuring out their gender and what path is right for them, I always see people tell them that there are a number of possibilities and only they themselves can figure out who they are and what is right for them (though, yes, books and therapists and talking to others can help).
Though this trope is often thrown out too, I really don't want to address “butch flight” because I was never butch or involved in any lesbian/womens communities--but Gauge wrote a great piece.
There is also the ableist idea that being in an unaltered (“natural”) body is more moral/better than being in an altered (“unnatural”) body. --This feeds into the idea that our differences mean we are defective and wrong and need to be cured or eradicated.
There is the idea that being trans* is caused by some defect in us; whether a defective uterus that gave us the wrong dose of hormones, a defective brain that makes us hallucinate, or a society that gives us defective socialization. While some forms of trans*ism may be caused by hormones in the uterus or brains that are shaped differently or whatnot, this is not a defect (seriously, natural variations in populations do occur!).
(Eli Clare has written a few things on the similarities and intersections of trans*ism and disability much better than I ever could)
This is, by the way, true even if you ignore the times we are called crazy, insane, psychopaths, nutjobs, etc.
(I don't really know where I'm going with this point exactly, I just don't think this trend should be ignored. Maybe someone who has a better understanding of ableism would like to look into it, I really don't feel knowledgeable enough to do so.)
ETA: Cedar's poem Diseased is amazing.