Throughout his philosophical career, Slavoj Žižek has always had an odd, idiosyncratic way of talking about Gender, Sexuality, and LGBTQ+ issues. At some points, especially recent times, it appears that Žižek simply parrots reactionary talking points about Gender and Sexuality uncritically, while at others, Žižek appears to be a kind of radical Gender Accelerationist. At least two years ago, in a public lecture on the subject, Žižek presented some questions to Judith Butler's form of Gender Theory which is anti-essentialist, and rooted in Historicism and Materialism. In his line of questioning, he is firmly against a form of identity rooted in any kind of essentialism.
In this lecture, Žižek questions the view held by some trans-individuals that they are simply “born in the wrong body”. However, this line of questioning isn’t used to deny trans-subjectivity, but is rather affirmed by positioning trans-identity within the realm of psychoanalysis and German Idealism. Trans-Identity, for Žižek in this lecture, is a kind of “free choice” which is radically free precisely because the “choice” appears to us as if it could not have happened in any other way.
The “choice” of Gender and Sexuality isn’t the same kind of choice of which soda to buy, or which Sports team is your favorite. Like a couple who falls in love, the decision is not made rationally (that is to say, via a calculus of pros and cons), but is rather a radical and necessary kind of decision where “you choose yourself” or the “choice chooses you”. As he says in another lecture, “authentic free choice, at its most radical, is always experienced as necessity”, or rather as a choice made unconsciously.
What appears to be essential is in reality radically contingent.
The radicality of this unconscious “choice” is in embracing -- either through medical or social transition -- what has so far remained virtual. The only point of criticism of so-called “trans-ideology” that Žižek makes in this lecture is when trans-identity is treated as if it were a kind of consumer choice, as opposed to the more radical choice which only appears to be made in advance. Or in other words, he is critical of when essentialist forms of identity are presented as a conscious capitalist choice, rather than something that merely appears to be essential. At least in this lecture, Žižek appears to avoid Gender Essentialism, while also affirming the radical necessity of trans-identity.
However, more recently, it seems that Žižek’s once nuanced and even radical takes on Gender and Sexuality have begun to either take a reactionary turn or at least lose some of the philosophical nuance and thoughtfulness which made his analysis interesting.
One of Žižek’s great contributions to philosophy is in articulating the juncture between German Idealism (Hegel, Kant) on the one hand, and Psychoanalysis (Lacan, Freud) on the other, while at the same time maintaining a proper Marxist analysis. Žižek’s analysis of Anti-Semitism in Sublime Object of Ideology is precisely in recognizing that is isn’t enough to say that the anti-semite is simply wrong about the facts of Jewish people (content), but that we must show that “the anti-Semitic idea of Jew has nothing to do with Jews; the ideological figure of a Jew is a way to stitch up the inconsistency of our own ideological system”(49). To detangle anti-semetic logic, it becomes necessary to show that the form of anti-semitism is in reality a flimsy ideological web which is used to cover up both the lack in one's own subjectivity, but also in the failure of the anti-semite to recognize the lack in the other. This is why Lacan and Žižek say that the “big other does not exist”. Subjectivity, for Žižek, is a void. Most prejudices (racist, sexist, homophobic, classist, as well as transphobic) are understood as a scrappy inconsistent way for Subjects to cover this void, or contradictions latent within Identity (which is always split).
Žižek is no doubt an animated, articulate, and provocative orator. Žižek’s style of argumentation is what has kept him relevant since the 90s. However, when Žižek has recently discussed trans-issues in his article “Wokeness is Here to Stay” on Compact Magazine, it's as if Žižek has allowed himself to buy into his own kind of big Other. It is as if Žižek has forgotten Lacan’s central teaching that the big Other does not exist!
It is not simply that he uses nebulous and vaguely conspiratorial phrases like “the trans lobby” and “wokeism”. These phrases, although philosophically and practically unhelpful, are not the source of the trouble in themselves. Following the release of Žižek’s article, the Lacanian internet lecturer, Julian de Medeiros published a 48 minute video on Youtube analyzing Žižek’s Compact article. For Julian, what appears to mirror the reactionary arguments made by Conservatives and Transphobes contains a twist. Or to put differently, although Žižek appears to be using the same exact language as those who fear monger about “the trans lobby” (in the same exact order or form), Julian believes that Žižek’s position within the article contains at least a kernel of Žižek’s more radical more progressive analysis.
The purpose of this article is to interrogate this proposition, both philosophically and practically. To be clear, this is not a defense nor simply an explanation of Žižek’s polemical article. Nor is it a way to “discard” Žižek, to condemn him for his sins.
It is not up to us to decide whether Žižek himself is transphobic, but the language and presentation of issues he displays in the article is disgustingly so. In some parts, Žižek is also factually incorrect, and seems to willingly misrepresent the complexity of the issues at hand. It is one thing to strategically use dog whistles against themselves to show their absurdity -- as Adorno once said “When philosophers, well-known for being averse to silence, enter into a conversation, then they should speak as if they were being proved wrong, but in a manner which convicts the opponent of untruth”1 -- it is another to simply be wrong.
Like Artaud, we wish to do away with the judgment of God, but we do want to investigate the ethical and practical impacts of Žižek’s article, especially where it goes wrong (which is to say, incorrect and reactionary). Following Guattari, we want to both affirm the need for structural transformation, without totally condemning micro-political struggles such as healthcare, and trans-affirmative legislation which are (mis)characterized by Žižek as examples of “woke capitalism”. Even if these measures simply reify the present state of things, we have a stubborn desire for our trans-siblings to have access to healthcare, and bodily autonomy.
In his Compact article, it isn’t so much that Žižek hasn’t researched the present issue at hand, but that his quality of research misrepresents the issue, often parroting the same kind of rhetoric of many TERFS and Transphobes. In an effort to skirt dogmatic thinking, Žižek ironically commits the same error which his article sets out to correct. Žižek uncritically puts forth false information, as well as repeating rhetoric which misrepresents the benefits of trans-affirmative health care.
Most importantly, we find Žižek’s characterization in his Compact article to be both philosophically incorrect, and practically unhelpful, and we want to provide an alternative.
To demonstrate these points, we will first discuss the importance of trans-healthcare, and the urgency of the current situation. Second, we will analyze Žižek’s article and provide our own philosophical intervention: an escape from State Psychoanalysis via Deleuze and Guattari’s schizoanalytic approach.
THE EXIGENCY OF THE
CURRENT SITUATION: WHY
On Saturday March 4th, 2023, while giving a speech at the Conservative Political Action Conference, The Daily Wire host Michael Knowles declared “For the good of society … transgenderism must be eradicated from public life entirely — the whole preposterous ideology, at every level”2. As Peter Wade and Patrick Reis report in their Rolling Stone article3, although Knowles insists that he was not actually calling for the extermination or genocide of Trans people, there is no rightful distinction between the eradication of so-called “transgenderism” and Trans people. Just as one cannot separate the so-called “Jewish question” from the deadly history of genocide and anti-semitism. One implies the other. One cannot eliminate ‘transgenderism’ without use of violence -- whether directly or structurally.
In the United States and the United Kingdom, the current situation for trans people is dire.
The ACLU maps an unprecedented amount of anti-trans bills which they are tracking in the United States, with at least 113 bills targeting trans-healthcare. Others target public accommodations-- specifically restrooms-- which, “provides requirements for exclusive use of restrooms & changing facilities by gender”4. Again in Florida, we see some legislation targeting education, with one goal of “prohibiting an employee, contractor, or student of a public school from being required to refer to a person using personal titles or pronouns that do not correspond with that person’s sex”.5 It seems that in many parts of the country, many policymakers think it is necessary to enforce which bathrooms people use, and legally sanction misgendering and deadnaming.
These are not trivial issues. Throughout the history of Civil Rights, bathrooms have often been the site for the struggle to exist more or less freely in public spaces. It is also telling that in the case of deadnaming and misgendering, the protections granted are for the employees and students who are choosing to deny referring to someone by the name and pronouns which they use. Both of these issues, as should be obvious, are rooted in a form of biological reductionism as well as bio-essentialism, because these legislations attempt (and some succeed) to reduce complex social dynamics, individual expression and experience, into what is perceived to be the purely “biological” (by which they mean, the genitals someone was born with and perceived sex characteristics). In reality, biology is not so simple.
Biology is nothing, unless understood through the historical, social, and material conditions which are always interconnected. Biology, psychology, history, and social relations form a complex dynamic which inform and influence one another. It is both reductionist and harmful to reduce complex phenomena to a vulgar bio-materialist view.
Biology is a factor in understanding and moving our bodies through society, but it is much more complicated than biological reductionism makes it out to be.
In other words, the State does not even understand what science is. The State believes Science to be a set of Laws, or a set of Judgements. In reality, Science can only describe what is necessarily creative and expressive (life).
Biology is not a set of laws to follow, but a descriptive science which seeks to explain phenomena via empirical observation and study. What these legislations do is close off and restrict the use of science which should be open and dynamic. The bio-essentialist wants to eliminate what they view to be anomalous because the existence of the non-denumerable (the minority) escapes the capture of their fatal abstraction and reductionism.
Many of the bills related to healthcare, such as in Florida6, Georgia7, Hawaii8, Mississippi and Arkansas9 (among others), specifically target the use of puberty blockers and gender affirmative procedures on minors. However, the extent of these bills are by no means limited simply to the prohibition of trans-affirming surgeries or hormones for minors. In Florida, for example, one measure proposed seeks to target funding for gender clinics by “prohibit[ing] health insurance policy & health maintenance contract from providing coverage for gender clinical intervention”10. Some States such as Hawaii, would “establish a Class A felony for those who perform gender reassignment surgeries on minors” if put into effect11. For comparison, other Class A felonies in Hawaii “include crimes such as murder, kidnapping, drug crimes, rape, and arson”12.
In England, the Tavistock Gender Clinic was the sole provider of trans and gender expansive individuals since 1989, until it was shut down this year. As Maggie Baska writes in the article “Why the Tavistock gender clinic is actually closing – and what it means for young trans people'', although the reason to shut down the clinic was due to an unsustainable case load, leading to ever increasing waiting lists for gender affirming care, “the press have continued to frame the decision as a win in their war on trans lives”13. Additionally, this leaves many trans and non-binary folks in England without gender affirming care for the near future. As it currently stands, it appears that the Tavistock clinic will be replaced by “two Early Adopter services” which “will be led by specialist children’s hospitals and, once established, will take over clinical responsibility for and management of all GIDS patients – including those on the waiting list – as part of a managed transition”. Additionally, it is said that when new facilities open, there will be further investment into research studying the potential long term effects and puberty blockers. For now, given the high caseloads and long waiting lists and slow planning of the NHS, it is likely this will not be a reality any time soon.
Clearly, such measures are at least framed to be in service to the children, or as Zizek calls them, the so-called “troubled youngsters”. However, as a Vice article points out, “Puberty blockers have long been used to treat precocious puberty (the medical term for early puberty) in cisgender children—safely, and without any controversy” (Smothers). Additionally, in a research article by Simona Giordano and Søren Holm15, they explain puberty delaying hormones are not often prescribed, and only done so in cases where the patient is experiencing the diagnosis gender dysphoria:
The assumption by many is threefold: (1) children and teenagers are too immature to understand the long term effects of puberty blockers or trans-affirming procedures, (2) doctors and medical professionals are providing these procedures and medicines haphazardly or without providing effective informative consent to youth patients, and (3) even if youth patients consent to such procedures or medicines, there is a chance that they change their mind later, thereby regretting their former decision. Or in other words, the third assumption believes that youth cannot effectively consent to hormone blockers, or other gender affirming procedures period, either due to a lack of brain development, or lack of emotional maturity.
While many of these criticisms can come from a good place, they are often parroted without acknowledging the actual perspectives of trans-youth, their parents, and medical professionals who support their gender transitions. A few of these criticisms can be effectively challenged simply by questioning their underlying assumptions.
For one, the decision to support gender affirming procedures for trans-youth, either medically or by other means, is not a simple exchange whereby a patient asks their doctor for puberty blockers or hormones, and they provide them without question. The long waiting lists to simply get an appointment with the clinic should show how absurd this assumption is16. According to the NHS, the process for youth seeking treatment for Gender Dysphoria was as follows17:
- Youth patients needed to be referred to Gender Identity Development Service (GIDS).
- The youth patient would be seen by a “multidisciplinary team” of professionals, such as “clinical psychologist, child psychotherapist, child and adolescent psychiatrist, family therapist, social worker”.
- “The team will carry out a detailed assessment, usually over 3 to 6 appointments over a period of several months” (NHS).
- Based on the results of the assessment, youth patients would be able to explore therapeutic options, and may receive a referral “to a specialist hormone (endocrine) clinic for hormone blockers for children who meet strict criteria”.
Furthermore, the NHS notes that “Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behavior or feelings disappear as children reach puberty”18.
On the NHS’s website cited above, they are clear that although there are minimal physical side effects for going on puberty blockers, and that puberty blockers are reversible once stopped, there is limited data on the potential side effects, as well as “whether hormone blockers affect the development of the teenage brain or children's bones”19. Only at the age of 16, once on hormone blockers for at least a year can youth patients receive gender affirming hormones such as testosterone or estrogen.
The exploration into the actual practices of the Tavistock clinic and GIDS is necessary to demonstrate 3 points: (1) receiving hormone blockers is not offered to every gender variant patient without question, (2) even when patients are referred to an endocrinologist to be put on hormone blockers, it is only after months of assessment with a team of professionals, and the youth patient must meet specific criteria, and (3) the potential risks as well as gaps in research are communicated both to the youth patient, as well as the parents of the youth patient.20
This is all assuming that the patient is even brought in the door within a timely manner, which is often not the case.
On April 5th 2021, a comprehensive case analysis of Tavistock V. Bell was published by the International Journal of Transgender Heath (C. de Vries, Richards, C. Tishelman, Motmans,. Hannema, Green, Rosenthalg). In their review, they review the ethics and practical impacts of puberty blockers on youth, how consent plays into the actual practices of clinicians and patients, as well as harm of not providing hormone blockers to those who may benefit21. It provides a very strong exploration of the subject which covers the affirmative positions for trans-health care for minors and adults. For now, we will cite a passage which rightfully points out the benefits of hormone blockers:
Continuing, they explain:
The point here is that hormone blockers have benefits for trans and gender expansive youth which are often overlooked. Medical intervention for trans and gender questioning youth is not the end-all-be-all but can be a vital piece in the puzzle when supporting their feelings around gender identity. Additionally, as another study shows23:
The question of hormone blockers for youth patients is a complex issue involving questions of informed consent, mental health, as well as medical ethics. However, the move to simply ban such practices from happening in the United States and the United Kingdom forces these complex questions into a black-and-white issue. We must also consider the ethics of how withholding medical treatment from youth also causes or leads to considerable psychological and potentially irreversible physical harm (such as self-harm, and unfortunately, suicide).
Unfortunately, these perspectives are often not considered leading to an oversimplification and misrepresentation of the issue. Instead of seeking to prohibit trans-health care to youth, policy makers could focus on ways to ensure the process is as safe as possible, and following WPATH standards24. If policy makers and “gender critical” skeptics were actually concerned about the wellbeing of trans-youth, they would not seek to get rid of their access to gender affirming healthcare entirely. Prohibition does not answer the complex questions of medical ethics which are negotiated between clinicians, counselors, doctors, psychologists, psychoanalysts, patients and their parents, but makes these questions impossible to answer.
If the rationale for hormone suppressors is to temporarily allow the question of gender to have time to think, its opposite attempts to prohibit exploration. Given this, one must ask, if the Right is so concerned about the force of so-called ‘Wokeness’, why is their main attack to cancel all forms of trans-healthcare?
Instead of an ethics of ambiguity, we get a stratified and reductionist Law of the State. Instead of using policy to open up dialogue about practices between practitioners, patients, and guardians, policy is weaponized to prohibit access to healthcare.
It should go without saying that access to healthcare for everyone (including trans-youth) is vital. Trans-Affirming healthcare saves lives, not only by providing essential mental health support through therapy and counseling, but also providing other forms of medical intervention when necessary.
Again, this does not mean that medical and psychological intervention is the end-all-be-all. It may in fact be a bandage which allows the symptoms of Capitalism to be even slightly more bearable. However, if we wish to call ourselves Communists, it is counterproductive to refer to life saving healthcare as ‘bourgeois’ and ‘woke’. Communist’s like us want more healthcare, not less. We want an open and dynamic kind of healthcare, not one whose regime is managed by a logic of bio-political reductionism.
ŽIŽEK’S COMPACT ARTICLE
AND ITS PROBLEMS
Now that we have explored some of the complexities of the issues surrounding trans-healthcare and livelihood in the United States and United Kingdom, we are at the question, “What is Žižek’s issue with so-called ‘wokeness’ and how do transgender identities fit into his critique?”.
As a philosopher who often concerns himself with Marxist, Hegelian, and Psychoanalytic subject matter, we would not be surprised to find out that Žižek’s critique of wokeness does not claim to come from a reactionary position of biological essentialism, but rather (at least attempts) to come from a more radical leftist position.
Or to state plainly, although Žižek appears to voice some critiques which come off as essentialist, this would be a very inconsistent position for him to hold given his common refrain that there is nothing underneath the surface of identity and subjectivity, but merely that identity is a set of formal relations, a web of signifying chains.
As referenced earlier, Julian explains how, in his opinion, while Žižek’s article does contain some rhetoric and critique which is not useful, and is in fact harmful, Julian believes the article does contain a twist which not only is consistent with Žižek’s overall body of work, and is also different in kind from the contemporary reactionary argument against trans-identity.
As we also argue, there are a few major problems with Žižek’s article. For one, Žižek cherry picks a few inflammatory examples to focus his analysis which paint a very deceptive story. In the case of Isla Bryson in Scotland, a woman who is said to have transitioned only after committing multiple sexual assaults, is presented as one of the problems of sexual identity when it is treated as a freely made consumer choice. Žižek says, “The point here is that there is no easy solution, because sexual identity is in itself not a simple form of identity, but a complex dimension, full of inconsistencies and unconscious features—something that in no way can be established by a direct reference to how we feel”. For this reason, Žižek is critical of the Scottish bill which makes it easier for trans people to change their legal sex.
The main problem here is that Žižek cannot possibly know when Bryson began to understand herself as transgender (or when she begun to experience gender dysphoria), and that even if Bryson is a bad actor taking advantage of the Scottish law (which, if she was trying to do this, was unsuccessful), this is obviously not the case for the majority of trans people who simply want to be recognized in-themselves. He also oversimplifies the issue, and doesn’t provide a thorough explanation of the reasons why this bill was put forth in the first place.
In reality, the Gender Recognition Reform Bill in Scotland makes the process for legally changing one's gender easier by no longer requiring that the applicant to have had gender dysphoria, a reduction of the allowable age from 18 to 16, removing the General Practitioner (GP) from the process, reducing the amount of time where the applicant must live as the acquired gender from 2 years to 3 months, and the introduction of a 3 month reflection period (Scottish Parliament).
Many of these changes should be understood as positive. As Abigail Thorn from Philosophy Tube pointed out in her video, trans people often find themselves in a kind of medical limbo when their GP simply refuses to deliver trans-affirmative healthcare due to personal reasons. Removing the requirement of a statement from the GP means that more trans people can legally change their acquired gender. Practically, this marks one less bureaucratic hoop that trans people need to jump though to simply live the lives they see fit.
Similarly, removing the requirement of a medical diagnosis of gender dysphoria removes another hurdle by no longer treating trans-identity as a disorder, and legally recognizing transitions of folks who do not experience gender dysphoria. This means that trans people who experience ‘gender euphoria’ can now also be legally recognized as their acquired gender.
Furthermore, to frame gender exploration as simply “discovering what one really is'' misses the point entirely. What we are dealing with are subjective intensities which are singular, non-signifying, and non-quantifiable. There is no universal “trans experience”, nor experience of gender whatsoever. The only kind of universality when it comes to trans experience is the openness to a radical difference -- something which is purely singular and intensive. We may “find ourselves” and we may use language to put words to our lived experiences, but this does not imply a cookie-cutter essentialism whereby one's experience of gender is felt universally. With that being said, given that gender experience is necessarily intensive, the only way to understand it is through sensations and affections: i.e. feelings. When we are talking about the experience of gender — which is a phenomenological — feeling is a primary and direct means for understanding said experience. Language may always be imprecise, and not fully capture the experience in a single word or set of pronouns, but that doesn’t make language useless.
When we are talking about securing the already slim rights of people, as well as health care or identification, the question of symbolization and quantification becomes necessary under our already reactionary (and genocidal) hellscape.
This may imply some kind of essentialism, but only as a radical kind which affirms the virtual which was always-already contingent. Why can’t it be that, as Žižek once argued, trans people are simply using legal identification to be recognized within their contingent lived experience? In other words, isn’t it possible that the appearance of essentialist logic is merely that: an appearance?
The question that seems to go unasked is, if Gender is not established by a reference to personal feelings or subjectivity, then how can we, practically, lay any claim to gender identity on a legal, personal, social, and medical basis?
It may be true that there is no easy solution. Maybe we must proliferate gender which in reality becomes genders abolition? Perhaps any reference to language stratifies gender within a concept? However, in the majority of cases, a gender affirmative approach is the only approach which allows trans people the most agency in self determination when it comes to their bodies, healthcare, and self-identification. We do not need psychoanalysis, medical science, or any kind of therapy to validate someone's existence as trans. It should not be up to general practitioners, psychologists, nor psychoanalysts to define someone else’s experience for them. These institutions and practices are not there to diagnose gender identity, but to support their patients.
Another major problem with Žižek’s article is how he implies that trans-affirmative health care and legislation is an example of ‘Woke Capitalism”. We will continue to address this moving forward, but suffice it to say here that this characterization of healthcare and legislation throws the baby out with the bathwater.
It is also, empirically and materially, incorrect. Physicians and clinicians are not being cowed or terrorized by the so- called “trans lobby” (which is actually a multiplicity of different trans- lobby groups). Rather, anti-trans lobby groups and Right wing political parties are using their political power to attempt to cancel trans people from existing -- by making it more challenging for trans people to exist in public spaces, prohibiting their access to gender affirming healthcare, and giving more allowances to those who seek to deny trans-livelihoods.
Even if Žižek is correct, it hardly seems necessary to abandon healthcare and trans-affirmative legislation as valuable causes, even if they are not the end goal in-themselves.
Despite this, Julian argues that Žižek’s article is ‘not a right wing or reactionary polemic’. Julian explains the difference between Right wing and Left wing argumentation: whereas the Rightist critique tends to focus on how symptoms of Capital are deviations from an a priori ‘natural order’, the Leftist critique demonstrates how the contradictions of Capitalism, and its effect on subjectivity, are immanent to Capital’s functioning. The Right believes in such a thing as a ‘natural order’ which it seeks to return, and where deviations are viewed as a decline of civilization. The Left does not insist in the belief of a so-called ‘natural order’, and instead ‘seeks to push through contradictions’ in order to bring forth a new kind of emancipated society.
While explicitly not defending the article, Julian explains that:
According to Julian, Žižek’s article does not wish to return to a natural order, but instead is consistent with his previous critique of political correctness, not from the Right but from the Left.
But is Žižek’s argument that “clinicians are cowed by the trans lobby” which is “compounded by a financial compulsion”, really an emancipatory position? Are “The use of puberty blockers [...] yet another case of woke capitalism”? Healthcare may be a commodity under capitalism, but private healthcare is hardly ‘woke’.
One aspect of what Žižek has pointed out in his essay “Wokeism is Here to Stay” is that as long as the means of production are owned by a class of bourgeoisie, various means of oppression will be used by the State to reify capitalist social relations. This can be a means of oppression involving the military, but also all of the aspects of social life which concern governance, such as national health, education, finance etc.
In the process of an ongoing global neo-liberalisation whereby public owned services are being privatized and sold to stockholders who are driven solely by profit, systems which on the face of it (prima facie) appear to be in service of our best interests are only friendly masks of Capital: A vampiric machine which converts living labor into dead labor; a machine that alienates a whole class of workers and forces them into conditions of poverty and crisis.
This is all well and good. It is true that Capital has a tendency to sell us our own escape, which in reality only secures us deeper into Capital’s logic. The problem comes from Žižek’s examples, which are both incorrect and unhelpful. Žižek suggests that access to puberty blockers is another form of ‘Woke Capitalism’:
Žižek has suggested that:
- There exists a trans lobby, a political force of capitalist reformist trans individuals who are able to create policy.
- Gender clinics do not properly assess patients, but are pressured into giving out puberty blockers.
- Puberty blockers are nothing more but a means for a group of new trans-bourgeois oppressors to produce profit from young trans and cis individuals by forcing gender clinicians to prescribe hormone therapy treatment before properly examining patients.
Let us respond by saying this:
Puberty blockers are a life saving medication for trans, non-binary and cisgendered people across the world. Access to HRT improves the lives of those receiving the therapy by reducing the possibility and risk of suicide amongst one of the most vulnerable minority groups25, whose murder and suicide rate is amongst the highest in the world26. Tavistock Clinic was a first in producing access to health care for gender issues in the UK, it was privately owned, and shut down once the government was persuaded to produce a national program concerning Gender Clinics.
The existence of the Tavistock Clinic, though flawed at many levels, was a step in progress for the safety and survival of gender dysphoric individuals. Without its origin, a new national program devoted to producing socialized gender clinics across the country has been founded due to the problems of the private form. Woke Capitalism has updated itself, it has been resisted from within, and is being continually dismantled to protect emerging forms of minority. Capitalism has historically been racist, sexist, ableist etc - it has always dominated and oppressed groups with less power who have no access to the means of production, and particularly has engaged in a historical massacre of particular, vulnerable minority groups within that class of bourgeoisie. It has disproportionately targeted women, trans folk, the homeless, the criminal, the disabled, the divergent, the non-white.
Žižek neglects to invoke his own Marxist Hegelian logic in his analysis of trans progression within a capitalist system. We have in our upcoming work Negative Map already produced this autocritique concerning Žižek's Marxism and Revolutionary theory in our opening chapter on Capital27. Suffice it to say here, Capital generates its own means of self-destruction. It also contains its own auto-critique.
Žižek understood in his own work the "self-revolutionary potential of capital", the ways in which Capital produces the tools for its own immanent emancipation. We have further elaborated on this concept which connects Žižekian Hegelo-Marxism with Deleuze and Guattari’s Logic of Schizophrenia (their Metaphysical Marxism) as Pitchfork Theory:
Yet gender-affirming healthcare, and legislation does not have to be abolitionist to be important and worth our consideration.
It is as simple as this: puberty blockers are health care. They are suicide prevention. Access to health care is essential for the livelihoods of multiple communities. Gender affirming care affects everyone.
Puberty blockers must, like everything within capitalism, be critiqued as a commodity form and revealed as a (commodity) fetish, as a means to produce capital. Whilst it is true that privatized health care is capitalism par excellence, since it is capitalism deconstructing a specific and particular form of its oppression on an intersectionalist level (making healthcare into a commodity), it is this same reformist deconstruction that contains potentials for revolutionary activity.
However, the quality of wokeness which Žižek predicates to the subject of Capital is the motor of a deterritorialization, or in other terms, a deconstruction. This deconstruction concerns the various intersectional areas of struggle, concerning class and the rest, but particularly the struggles of recognition at various levels within capitalism: racial, sexual, gendered, abled, et cetera.
If a so-called 'social progression' emerges under capitalist conditions, though seemingly not directly participating in the class struggle for socialist conditions, is it fair to say that there is no progression made at all?
Wokeness, used by 'marxists' and Conservative right wingers alike, is the expression that social progression - such as that of identity politics, vegan and eco activism, civil rights - is a false progression. In fact, these woke prescribers can see social progressions of these kinds as degressions. Wokeness is seen by some to 'muddy the waters' of a clear and orthodox Marxist-Leninist theory which sees only one struggle worth genuinely recognising, acknowledging, and even participate in. All other forms of struggle are deemed illusory. Meaningless. Counter-productive. Liberal. Identarian. Reformist. Pseudoproblems.
They fail to acknowledge this so called reformist, woke motor contains revolutionary potential. It is a form of resistance to power that has only emerged in a capitalist form. A fetal stage. Žižek produces a logic he ascribes to Luxembourg and Benjamin, that "there are no perfect conditions, the revolution will only emerge through its failed attempts" - the Hegelian logic that there is success hidden in the form of failure - would Žižek not see here also that any so called woke project immanent to capitalism is itself the emergence of a revolution which begins in failure? The private clinical production of trans health care is a failure at the level of class struggle. This is due to its nature of being private, as opposed to public. Is trans health care then too failed? No. It is an essential success of a minority who belong to the proletariat, it is one of the first legal and medical (though these systems aren't without political flaws) means for a group to achieve recognition and access to a life saving form of care.
Without this, the actualisation of a means of survival for a minority collective, there would be no real potential for a revolution of class struggle proper. What is the nomads' revolutionary activity? Their existence. Their survival.
By surviving under capitalism as a minority class they produce new means of resistance.
‘Wokeness’ is a way to dismiss a struggle at the level of survival, to dismiss revolutionary potential as too other, too alien, too detached from reality. Too subjective.
Why not flip this logic on its head? Why not harness the desire brought by subjectivity, and weaponize it towards a new world build in the shell of the old?
Puberty blockers as a commodity used privately or by the state to produce profit and capital for a ruling class is Capitalism. But the use value of puberty blockers is in keeping alive an underclass and oppressed minority who have the most reason to despise capitalism.
Puberty blockers are a resistance to capitalism which has been embraced by capitalism.
It is a resistance which has been proliferated from private to public, which has abolished itself as a commodity form (even if it came into its recent existence as such) and now serves only the benefit of its users. This would not be possible without its flawed, capitalist conception.
All of this is to say: the only correct assumption is that puberty blockers (like all medicine under Capitalism) are a commodity. But, like insulin or other medications, it is possible to recognize that it exists and is exchanged under Capitalist social relations, while also accepting its necessity. We are Communists. We want more healthcare, not less.
Unfortunately, Žižek's article reads more as a means for Orthodox Marxists, Class Reductionists, and Transphobes to argue for the disapproval and removal of puberty blockers and hormone therapies. It serves as a useful way for class reductionist revolutionaries to dismiss the existence of trans people and their existence as a unique struggle against capitalism at the level of subjectivity and production. It reduces trans struggle for life and healthcare to identity politics, and dismisses trans health care as a purely capitalist phenomena which only serves to maintain and uphold the existing state of things.
Healthcare might serve to uphold the existing state of things to some degree, but it would be stupid and cruel to kill your doctor, or to burn down clinics and hospitals. To attack healthcare is itself self-defeating.
Žižek's neglects and fails to recognise the revolutionary and emancipatory potential unleashed by hormone therapy. In keeping a class of oppressed subjects alive, it promotes the opportunities for an immanent resistance to and dismantling of capitalism. It keeps trans people alive to fight and participate in the class struggle. It is Capitalism engaging in its own self-abolition. It's aufheben or aufhebung. Self-revolution.
So-called ‘Woke Capitalism’ therefore highlights the points of contradiction within Capitalist modes of production, intersectionalist progressive waves and movements that entirely are bound up within class struggle. Points of departure from the existing mode to a new mode. Whilst it does not directly dismantle capitalism, it opens up potentials for dismantling capitalism which previously were not available. It keeps alive new channels of resistances which are being actualized now. The struggles of trans individuals and proletariat are entirely the same. Success for one is success for the other. Both are engaged in a becoming-minor: in the construction of war machinery to deterritorialize the Capitalist war machine. It is a single victory, where we must "win twice".
From the perspective of schizoanalysis or materialist psychiatry, we must at once like Žižek has, analyze all existing structures and institutions under capitalism, especially those concerning health - what Foucault calls Biopower - as means to reify and maintain the existing mode of production of bourgeois ownership. And at the same time we must seek to promote and unleash the revolutionary potential of the proletariat class in their seizure of the means of production in their self-abolition (aufheben) as a class.
Puberty blockers are not woke, though they existed in a privatized, commodity form. Thus they uphold capital and its logic. Let us not get it twisted, the problem is the private ownership of gender affirming care (most of which is for cis gender people) not the existence of gender affirming care. This would imply that gender issues are purely symptomatic of capitalism, rather than something produced by the subjective desire (desiring-production) of the masses which gets appropriated by the state and capital.
Žižek gets the order reversed, which is the source of the problem.
1Theodore Adorno, Minima Moralia, #44
2“CPAC Speaker Calls for Eradication of ‘Transgenderism’ — and Somehow Claims He’s Not Calling for Elimination of Transgender People: There is no separating a ban on “transgenderism” from an attack on transgender people, says activist Erin Reed: “They are one and the same, and there’s no separation between them”BY PETER WADE, PATRICK REIS.
4“The Florida Senate.” House Bill 1521 (2023) - The Florida Senate. Accessed March 26, 2023. 5“The Florida Senate.” Senate Bill 1320 (2023) - The Florida Senate. Accessed March 26, 2023.
6CS/HB 1421: Gender Clinical Interventions.
7Georgia, SB 141.
8Hawai State Legislature, HB891.
9Arkansaw State Legislature, “SB199 - Concerning Medical Malpractice and Gender Transition in minors; and to create the protecting minors from medical malpractice act of 2023”.
10The Florida Senate, “CS/HB 1421: Gender Clinical Interventions”
11Hawaii State Legislature, “HB891”
12“Felony Cases in the State of Hawaii.” n.d. Bilecki Law Group. Accessed March 26, 2023.
13Maggie, Maggie. 2023. Review of Health Why the Tavistock Gender Clinic Is Actually Closing – and What It Means for Young Trans People. Pink News. February 22, 2023
14“Hm, No One Had a Problem with Puberty Blockers When Only Cis Kids Took Them.” n.d. www.vice.com
15Giordano, Simona, and Søren Holm. 2020. “Is Puberty Delaying Treatment ‘Experimental Treatment’?” International Journal of Transgender Health 21 (2): 113–21.
16”How Long Is the Wait for a First Appointment at GIDS?” n.d. Gender Identity Development Service: In May 2022, there were 5,035 people on the waitlist.
17NHS Choices. 2019. “Treatment - Gender Dysphoria.” NHS. 2019.
20Also see the subsection on “the age of consent” from this article: Vries, Annelou L. C. de, Christina Richards, Amy C. Tishelman, Joz Motmans, Sabine E. Hannema, Jamison Green, and Stephen M. Rosenthal. 2021. “Bell v Tavistock and Portman NHS Foundation Trust  EWHC 3274: Weighing Current Knowledge and Uncertainties in Decisions about Gender-Related Treatment for Transgender Adolescents.” International Journal of Transgender Health, April, 1–8.
21Vries, Annelou L. C. de, Christina Richards, Amy C. Tishelman, Joz Motmans, Sabine E. Hannema, Jamison Green, and Stephen M. Rosenthal. 2021. “Bell v Tavistock and Portman NHS Foundation Trust  EWHC 3274: Weighing Current Knowledge and Uncertainties in Decisions about Gender-Related Treatment for Transgender Adolescents.” International Journal of Transgender Health, April, 1–8.
22Vries, Annelou L. C. de, Christina Richards, Amy C. Tishelman, Joz Motmans, Sabine E. Hannema, Jamison Green, and Stephen M. Rosenthal. 2021. “Bell v Tavistock and Portman NHS Foundation Trust  EWHC 3274: Weighing Current Knowledge and Uncertainties in Decisions about Gender-Related Treatment for Transgender Adolescents.” International Journal of Transgender Health, April, 1–8.
23Giovanardi, Guido. 2017. “Buying Time or Arresting Development? The Dilemma of Administering Hormone Blockers in Trans Children and Adolescents.” Porto Biomedical Journal 2 (5): 153–56.
24“Standards of Care - WPATH World Professional Association for Transgender Health.” n.d. www.wpath.org: “Criteria for Puberty-Suppressing Hormones. In order for adolescents to receive puberty-suppressing hormones, the following minimum criteria must be met: 1. The adolescent has demonstrated a long-lasting and intense pattern of gender nonconformity or gender dysphoria (whether suppressed or expressed); 2. Gender dysphoria emerged or worsened with the onset of puberty; 3. Any coexisting psychological, medical, or social problems that could interfere with treatment (e.g., that may compromise treatment adherence) have been addressed, such that the adolescent’s situation and functioning are stable enough to start treatment; 4. The adolescent has given informed consent and, particularly when the adolescent has not reached the age of medical consent, the parents or other caretakers or guardians have consented to the treatment and are involved in supporting the adolescent throughout the treatment process”
25GenderGP. 2021. “New Study Shows Gender-Affirming Care Reduces Teen Suicide.” GenderGP Transgender Services. October 25, 2021.: “In a study presented to the American Academy of Pediatrics, research showed a 60% decrease in moderate and severe depression who received gender-affirming care. Additionally, there was 73% decrease in suicidality among transgender youth and non-binary youth. A fantastic feat for a community with an alarmingly high transgender suicide rate”.
26Ibid: “In the US, 52% of Trans and Non-Binary youth have sincerely considered killing themselves in 202“
27Excerpt from our upcoming book: