ABSTRACT
This chapter develops an understanding of the options presented once a trans individual enters into the medical system. I focus on how the potentially pathologising elements of the guidelines regulating the care and treatment of transgender people may impact the degree of choice and agency offered to them. I examine motivations around physical change and asks whether there is pressure to undergo surgical transition. In comparison, the pathway for non-binary people has sometimes been less clear and it is an important and telling question as to whether the medical profession offers the same surgical options if the outcome is to create a body which does not try to conform to any gendered expectation. While many scholars argue that the nature and degree of an individual’s transition is their own choice and while such treatment can certainly save lives, the choice is made in and restricted by a wider context of social expectation and dominant models of service provision. This chapter critically examines transition pathways from a structural perspective, taking the onus from the individual and developing an understanding of the system they are required to navigate to receive support.
