The curious incident of the healthy transwoman

by Angus "Andrea" Grieve-Smith

I've noticed that transgender health researchers tend to focus on people with health problems, and that makes sense. Consequently, I've often felt a bit guilty talking about transgender health issues. I don't have a sexually transmitted disease, the worst thing I'm addicted to is sugar, I've never been bashed, and I'm not depressed or suicidal. So why should I talk about my health? Why would any researcher want to study someone like me?

The answer comes from Sherlock Holmes, in the story "The Silver Blaze":

Gregory ( Scotland Yard detective): "Is there any other point to which you
would wish to draw my attention?"
Holmes: "To the curious incident of the dog in the night-time ."
Gregory: "The dog did nothing in the night-time ."
Holmes: "That was the curious incident."

There's a fancy word for this: negative evidence. Often, the absence of a salient event can tell you more about the causes of a problem than a hundred events.

I see this all the time in my computer consulting business. If a customer is not getting an image on their computer monitor, it could be caused by a fault in the motherboard, the video card, the video cable, or the monitor. I can turn on the computer and get a blank screen a hundred times, but that doesn't help me figure out which component is causing the problem.

If I can get a picture even once, however, I can isolate the problem. If I hook the computer up to a different monitor and the display comes on, I know that the monitor is the problem. If I put in a different video card, I know the customer needs a new video card.

This method can work with transgender health as well. We are a diverse group, and there may be something in family background or upbringing that can make the difference between health and sickness.

There are many choices that we make in our lives, and those choices may affect our health. We need to know the consequences of those choices. Even if that knowledge doesn't ultimately change our decisions, it can prepare us and allow us to plan better.

That is why we need to hear about a whole range of transgender people, not just those that the researchers were able to track down.