If there’s one argument against affirmation-only approaches to gender dysphoria that makes me deeply uncomfortable, it’s this one: “you wouldn’t tell an anorexic she’s fat” (or variations thereof). It’s not that I don’t think that’s true, or that there aren’t striking similarities between those whose flight from the body takes the form of self-imposed starvation, and those who resort to sex denialism, drugs and surgery. It’s that the kind of things people do say to anorexia sufferers can represent the opposite extreme. 

Far from affirming the beliefs of anorexia sufferers (plenty of whom don’t simply “think they’re fat”), many people, from family members to medical professionals, will insist that everything an anorexia sufferer believes about food, weight and “what might happen if you get bigger” is a delusion. Then the sufferer might gain weight and find that actually, no — about some things, they were correct. 

It’s one of the reasons I think recovery can be so precarious and painful, particularly for those who became ill around the onset of puberty and/or those whose illness emerged in the aftermath of sexual abuse. Some harmful, untrue beliefs must be discarded — for instance, that it is possible to survive at a very low weight, or on a very low intake of food — but it can sometimes feel as though you’ve been invited to recover into a world that does not exist. Growing breasts will expose you to harassment? Nonsense! The way people respond to your larger self won’t correspond to how you feel inside? Don’t be so silly! You’ll always feel alienated from a body that sends out messages without your consent? That’s the illness talking! Post-anorexia, you can find yourself in a no man’s land, torn between feeling gaslit by the people who told you it would all be fine, and ashamed of not having the magical ability to control how you feel about where your body situates you now.  

Three decades after my last hospitalisation, I still have moments when I think recovery from anorexia made me less of my “true” self. There’s no need to tell me I might otherwise be dead — I know this, but there is a way of fully inhabiting my own skin that feels forever out of reach. If certain memories could be erased, and certain social meanings surrounding the female body were to vanish overnight, perhaps I might be able to attain it, but such things are not possible. Instead, one has to live with a certain discomfort, a discomfort that isn’t an illness as such, or proof that the wrong path was taken. I often wish we could be more honest about this. 

What does it mean when people push you to go through a life stage you desperately wished to avoid, especially when these people refuse to acknowledge what it will cost you? How do you square their denial with your own denial about the costs of staying frozen in time? I wouldn’t call what’s happening conversion therapy. It’s something much messier, something much more imperfect, but it can definitely feel like a robbery of the self. “The general consensus is that the patient has recovered,” wrote Susie Orbach in Hunger Strike, “when the normal weight is reached and appropriate sex role functioning is achieved.” When you are a “normal” person, in a “normal” body, whatever the implications for how you have to operate in a ‘normal’ world. 

For a long time after my own recovery, I was angry. I felt conned by all the people who had claimed to know the relationship between my body and my selfhood better than I, the apparently delusional one. Then again, I only occasionally flirted with starvation from my twenties onwards (despite the odd fantasy of “proving them all wrong”). I’d realised it was pointless, and that realisation had spoiled things. I hadn’t wanted to know, but couldn’t now un-know, that sometimes there isn’t any other space to occupy but this one, the one in which you never quite “are” the body you have. The alternative is lying to yourself, demanding the world lie along with you (it won’t) and/or destroying yourself completely.

I think this uncomfortable space might be one you have to inhabit after any flight from physical growth. To someone who is starving herself, you can say “if you do not eat you will die”. To someone who fears going through the “wrong” puberty, you can say “that’s the only one you can go through”. To someone who wants to change sex, you can say “you will always be the sex you are”. What you can’t say is that it is easy to adapt to these truths, or that you will definitely reach a state in which the feeling of discomfort will go away. That stuff is personal and unknowable, but it is possible — individually, relationally, politically — to think about how the world could be made more hospitable to every self in the only body they will ever have. 

This is why I baulk at the fact that Labour have restated their commitment to a “full, trans-inclusive ban on conversion practices”. What do they mean by this? I understand that because trans activists have piggybacked on LGB activism — and because, if you look at it from a (very long) distance, trans activism seems to be about supporting gender non-conformity — you could think there’s a “trans” version of anti-gay conversion therapy. I also understand that if “anti-trans conversion therapy’” involved forcing/coercing/threatening someone to conform to masculine or feminine gender norms despite their true feelings, that would be wrong and we should do something about it (indeed, we already have a movement that has done something about it — it’s called feminism). But how does this relate, say, to someone saying they cannot survive unless they’re treated by everyone as though they’re the opposite sex, all the time, or unless they are given medical interventions which literally change what sex they are? Because these things aren’t possible. They’re as impossible as surviving on air alone.

It isn’t necessary to tell someone that the truth will set them free — often it won’t, and it’s painful. But the truth is the truth, and I cannot see a way in which a “trans-inclusive ban on conversion practices” would not make it impossible to actively guide someone towards acceptance of the things they cannot change. In this way the comparison with anorexia is absolutely apt. Telling someone their sex cannot change is not the same as telling someone they can’t love the person they love; it’s the same as telling someone that they are not superhuman, because no one is. There is an equivalence between “gay” and “not gay”; neither is better than the other. There is no equivalence between “in flight from your body” and “not in flight from your body”. The latter isn’t perfect, but the former is worse — not as a judgement on a human being, but as a measure of a person’s capacity to be at relative peace with themselves and others.

The proposed ban has little to do with helping people to live as full a life as possible, as freely as possible

For all their declared opposition to conversion practices, it’s notable that the righteous and good have had little to say about, for instance, the United Nations Free and Equal campaign declaring that “lesbians have many gender expressions, body types and sex characteristics. They are also of any race, ethnicity, class or background”. As Jo Bartosch writes, “no one really needs to be told that, as a group, lesbians are diverse … What they don’t have, however, are penises”. By conflating being same-sex attracted with being racist or classist, the UN campaign seeks to morally shame lesbians out of feeling their own desires are legitimate. Lesbians are being encouraged to associate their sexual orientation with the sin of bigotry. Sure looks coercive and homophobic to me! But not, apparently, to the kind of person currently legislating for a “full” ban on conversion practices.

The proposed ban has little to do with helping people to live as full a life as possible, as freely as possible. It is about fashion, and admitting that sometimes, we have to live in the middle — shaped by others, by our times, by the limitations of our own bodies — isn’t fashionable. Flight from the body must be categorised as either a total delusion or a natural response to being in the “wrong” one (it’s not escaped my notice that the group deemed completely deluded is the one historically associated with teenage girls, while the one granted full credibility is led by adult males). We resist accepting that such flight is simply an awful thing far too many people engage in, for all sorts of reasons, in all sorts of ways, but always in the context of having a body that is either male or female, and needs to grow and change.

Sometimes I find it staggering that things are so backwards. In the name of letting people be their “true selves” we silence a million conversations on how people really feel. You wouldn’t tell an anorexic she’s fat, but you might want to entertain the idea that her sense of alienation is not rooted in total madness. The question is, what can be done about it, for everyone?