Tracking the ‘affirmation’ in transgender studies

Early notes on the spatial and temporal registers of the 'affirmative'.
By Dr Shawna Tang

I am interested in tracking when and where the term ‘affirmation’ have come into circulation in transgender studies.

With the help of Sophie Gillfeather-Spetere, we conducted a literature search using the library database of the University of Sydney. Up to 70 papers were collected, containing the words “trans”, “young people” and “affirming/affirmation”.

The figure shows the rise in affirming/affirmation discourse in the literature from 2012:

The contemporariness of this rising discourse is interesting to me, as is the space in which this discourse operates.

Spatial register

We locate most of these papers in medical and healthcare scholarships, in which gender affirmation is the lexicon and framework for models of medical care for young trans people. As an expression of this, “surgical interventions” for trans youths is now discursively refashioned as “gender affirming surgery” (Sevelius 2013:2).

“Affirmation” is a dominant discourse in transgender medical care settings but it has also become central to a broad understanding of what care means, including how we talk to and identify with transgender youths, as seen in this guide for “how to communicate about transgender youth.

Young trans people thrive when they are being affirmed, it is stated in the guide.  “Affirmation” is not just connected to medical care but also about “overall wellbeing”; it is about “telling positive stories”; and “using a moral argument”.

Temporal register

In thinking about the temporal registers of ‘affirmation’, I am struck by its contemporariness and its attachment to a futurity, “emphasising future impacts of doing the right thing.”

I am interested in thinking about these multiple temporalities of the “affirmative” discourse. On the one hand, the reminder that we should affirm young trans people is an important one. And these reminders to affirm have become increasingly dominant as a medical and political response to high rates of self-harm and depression among transgender youths in Australia and elsewhere (Zwickl et al. 2021; Butler et al. 2019).  On the other hand, I also wonder what this means for grappling with the past: the fraught histories that reveal gender and sexuality as cruel captures of power rather than identities to be positively affirmed. For young transgender boys today, the use of testosterone is an affirmative form of care. But testosterone extraction and hormonal treatments were historically tied to very brutal racialised regimes of incarceration, as Ethan Blue (2009) and others have shown. In recuperating this history, my point is not to criticise or shame young transboys’ desires but to grapple with the more complex “truths” of sex and gender, the inherent racialisation of these categories and how the young trans child may, worryingly, function as a stabilising figure. Trans “affirmative” discourse in medical settings inadvertently contributes to the ‘truth’ of normative sex and gender, and while the reproduction of binaries of sex and gender in the medicalisation of trans bodies have been subject to feminist criticism, there is also a race critique here: normative sex and gender, and indeed transnormativity, are forms of whiteness.

As trans affirmative discourses circulate dominantly, I think it is important to embrace this positivity, but I also caution against reading affirmative practices in a progressive, linear sense. Instead, what we need to develop is a more complex affirmative feministic politics and here I suggest we might do this by reading multiple temporalities in conjunction with each other.


Blue, E. (2009). The Strange Career of Leo Stanley: Remaking Manhood and Medicine at San Quentin State Penitentiary, 1913–1951. Pacific Historical Review, 78(2), 210–241.
Butler C, Joiner R, Bradley R, Bowles M, Bowes A, Russell C, Roberts V. (2019). Self-harm prevalence and ideation in a community sample of cis, trans and other youth. International Journal of Transgenderism. 16;20(4):447-458. doi: 10.1080/15532739.2019.1614130.

Sevelius, Jae M. (2013) “Gender Affirmation: A Framework for Conceptualizing Risk Behavior Among Transgender Women of Color.” Sex roles 68, no. 11-12: 675–689.

Zwickl, S., Wong, A.F.Q., Dowers, E. et al. (2021). Factors associated with suicide attempts among Australian transgender adults. BMC Psychiatry 21, 81.