What trans women need is more and better hair

Hello gorgeous and friendly people. I got new hair yesterday. The people at the Hair Club (formerly for men, but now for all people) glued the hair to my head, so I can sleep in it and wear it all the time. I am very satisfied with the hair for now–although it remains to be seen how it will weather.

Lots of talk on Twitter recently about how there are almost no trans women publishing YA (there were no books by and about transfems in 2023, and mine will be the only one published in 2024).

I think one underappreciated reason why there are fewer trans women than trans men writers in the YA world is that when you’re a trans woman, particularly one who is attracted to men, there’s just an extremely strong temptation to go stealth. If I didn’t have a public-facing career already, I would seriously consider whether it was worth outing myself to the world and making being trans a large part of my public identity. I’m not saying that I could fully pass (i.e. never be clocked by anyone in my life as trans), but a lot of women can, with the right procedures, and after my face surgery, I’ve definitely seen how it’s possible to get closer and closer to being taken for a cisgendered woman.

Of course it is EXTREMELY expensive. Like, gluing hair to your head aint cheap. Hair transplants are even more expensive (I was quoted 18k by a surgeon recently, and he said I might also need a follow-up set of grafts, for another 10k). I’ve also gotten at least sixteen laser treatments, at a cost in excess of, what, three or four thousand dollars? And I get electrolysis nearby for my remaining facial hair, which costs $105 (plus tip) per half hour. Everything is expensive. Another reason trans women don’t become writers–it doesn’t exactly pay.

But of course that’s not the whole story, because I know at least one trans women who’s had a lot of difficulty selling her (great!) YA manuscript, and I know several more who’ve had trouble selling books for adults. There is obviously, to me, some active bias against trans women.

I’m not personally that interested in the politics of representation. Trans women are such a small part of the population–it’s hard to say what the ‘right’ number of books by trans women ought to be. And in my case, it feels a little undignified to complain about lack of representation or attention, since it feels like I’d just be asking for more attention paid to MY work.

Recently I’ve been thinking more about how life-changing my face surgery has been. Ever since the procedure, I’ve quadrupled my effort to present as a woman at all times, in all situations. It wasn’t a conscious choice: it’s just that since my face surgery, my dysphoria has gone down significantly and the amount I’ve been misgendered has also gone down quite a bit–I can go weeks now without being called ‘sir’ or being referred to with male pronouns.

Having the surgery covered by insurance was an immense gift. I honestly think there is no place in the world other than California where this would’ve been covered, and that a large part of why it was covered was because of a recent bill passed by SF’s state senator, Scott Weiner, that put pressure on insurers to cover all gender-affirming care. Whenever people complain about the healthcare system, folx are like, “This is why we need socialized medicine!” Countries with socialized medicine often have major barriers to entry for trans people, they have big gate-keeping requirements and huge wait lists. The UK is a famous example, but my understanding is many nordic countries are similar. To some extent, a free market system is good for trans women, because we can just shop around and find a doctor who’ll prescribe the hormones we need.

But even in America, Facial Feminization Surgery is often held to be cosmetic (I mean, it is literally done by plastic surgeons, and it often includes procedures, like lip lifts and rhinoplasties, that are done on cis women), but for a trans woman it’s not really cosmetic: it substantially improves our health, safety, and mental well-being.

Now could I have lived without it? Of course. So for some limited definition of medical necessity I can understand how it could be unnecessary. But there are a lot of things people can live without. It’s possible to define ‘wellness’ rather arbitrarily. If you look at this surgery on a pure cost/benefit level, it’s clearly worth it: it has the potential to give adults many more years of life and well-being. Compare it to, say, chemo and radiation for low-survivability cancers (like lung cancer), and FFS clearly has a better cost/benefit ratio. Not that people shouldn’t cover cancer–just that FFS should be covered too!

I think the number one thing all trans women (in particular) need, and the single political interest we all share, is the need for proper medical treatment. For me, that is our baseline political interest. Representation is important, of course, but medical care is critical. The situation in Florida right now is horrifying. They passed a bill that makes medical care for trans adults essentially impossible. I cannot imagine what the ninety-five thousand trans adults in Florida (the nation’s second largest population of trans adults, after California!) are going through. Donate money to Spektrum if you want to help!

It frustrates me when medical systems embrace gender-inclusive language, but don’t prioritize gender-affirming care. At UCSF, for instance, every medical student gets taught about pregnant persons and people with prostates, etc, and I can attest that they are VERY good about gendering people correctly. I once went to the emergency room and gave them my legal name and they went boop boop in their computer and were like, “But you’re really Naomi right?” At the same time, the UCSF trans clinic isn’t accepting new referrals, and, when it was, it took months to get appointments. If UCSF prioritized training other doctors in its various clinics to monitor and assess HRT, they would help a thousand times more trans people.

I can guarantee you that most trans women would rather have a doctor feelgood who doesn’t give a fuck and prescribes them the meds they need at the proper dosages, as indicated by any simple google search, than they would have a conscientious doctor who writes them up a nice little referral to an EXTREMELY overbooked trans clinic.

There is an extent here to which trans women’s needs diverge from those of non-binary people. Trans women make the highest use of the medical system, while many non-binary people don’t need medical intervention for their gender dysphoria–what they need is to be gendered correctly in social situations. I am not against non-gendered language, but for me personally, it is a much smaller priority than proper medical treatment is.

Some trans women experience anger against nonbinary people. For a binary trans woman, the more medical and surgical intervention you get, the less harassment and dysphoria you experience. So a trans woman’s path to being able to use the proper restroom, for instance, is simply to look feminine enough that nobody bothers her. A nonbinary person doesn’t have that route open to them. Nonbinary people are at odds with gender norms in a way many binary trans women are not. People with a visibly gender non-conforming experience call into question gender norms that some trans women, in some situations, can use to our advantage (by being so ultra femme that it’s hard to see us as men).

Personally I don’t think this is worth getting worked-up about. I find the large and growing number of nonbinary people to be very comforting. My YA editor isn’t nonbinary, but he is genderfluid, which provokes some of the same complaints, by trans women, that he might have some kind of privilege (i.e. he is transmisogyny exempt) that trans women don’t have. My therapist is nonbinary. Lots of trans-friendly medical providers and nurses are nonbinary. Lots of people who date and love trans women are nonbinary. And LOTS of the activists at the forefront of the movement to protect trans rights are nonbinary, gnc, gender-fluid, or are queer in other ways complicate gender. To me, that’s great. I feel like the more people who think “An attack on trans rights is an attack on my rights,” the better.

I don’t totally understand some of the things nonbinary and gnc and genderfluid people want. For instance, I want people to intuit my pronouns from my appearance. I do not like pronoun-sharing circles. I like highly-gendered environments. A friend described going on a trip w her trans woman wife, and everyone called them ladies, and the wife loved it but my cis woman friend was like, “Don’t you talk about my gender!” I would’ve totally felt how the wife did.

I do not want to be visible. When I was a man married to a woman, I liked being straight! I didn’t feel like my queerness was hidden or effaced. I kind of mourn my straightness now that I’m in a lesbian relationship. I would much rather just blend in and not have my queerness or transness be a big part of my public identity. Which brings me full circle, to my feeling, sometimes, that I’ve made the devil’s bargain by being such a visibly trans writer.

There was no other option of course. I wanted to write about trans girls and women, for one thing. And for another I already had a career as a writer under my male name, and I didn’t want to give that up. But there was also a more complicated psychology. Back when I was less femme and less visibly a woman, writing about trans women was a way for me to claim womanhood. At least on the page, I was fully a woman. Now I don’t have the same insecurities. But, honestly, I’d do the same thing all over again.

Anyway, what I would like, going forward is to start writing a bit more about the practicalities of transitioning. Because there is the emotional side of it, obviously, but there’s also the physical side. For instance I didn’t even know you could get a wig glued to your head: if I had, I would’ve done it sooner! And the reason I didn’t know is that trans women who glue wigs to their heads obviously don’t want people to know about it!

But since I am so visible, I thought it would be good to pierce some of that veil. To that end, I am going to add another little tab to my website, where I link to some of transitioning advice. Probably not of interest to most of you, but since this site is still indexed by Google, it’ll be out there forever when any woman is looking up “trans woman wig glue to head?”


I’ve gotten back into watching movies. I’ve watched a few in the theaters:

  • Master Gardener – Another Paul Schrader flick about a sensitive older man falling for a younger woman. This time it’s a former Nazi falling for his half-Black apprentice. Not bad, but First Reformed (where Ethan Hawke was a pastor falling for a young war widow) was a lot better. This movie was thematically unfocused, and it didn’t seem to have much to say about race and hate.
  • Polite Society – A martial arts flick about a Pakistani girl trying to save her sister from a terrible arranged marriage (set in the UK). Really loved it. Liked it so much I saw it twice, not sure it held up on the second viewing, but how many movies do? It’s set in one of these alternate world where everyone, including middle-aged evil Pakistani women, knows martial arts. Very fun.
  • Also watched several more Wong Kar Wai films. I thought Chungking Express felt a bit unfocused, though I loved the male lead in the first story–he was adorable. But Days of Being Wild was excellent! Different from In The Mood For Love but also the same. It’s a freer movie, looser, less claustrophobic, and you’re never sure where it’s going. In the intersecting stories and happenstance and grand scale it reminded me a bit of Doctor Zhivago. Was perfectly satisfying, albeit heart-breaking.
  • Also saw Jean Renoir’s Rules of the Game, about a bunch of rich French people who all sleep with each other. The genius of the movie is that nobody quite seems to know that there are rules of the game. There is a sense, amongst various people, that we should be a bit adult about romance, but when it comes down to it, there are still lots of feelings involved, and their very adultness gets in the way, so they aren’t sure what they want or how to ask for it. Great film. Very funny too.


Haven’t done as much reading lately. And I also altered the way I track what books I read (I am using a database system instead of a spreadsheet), so it’s a bit hard for me to quickly call up a list of the books. However I’ve been making an effort to read the various paper books I’ve accumulated since the pandemic began. A few of the better ones:

  • Fontamara by Ignacio Silone – Published in 1930, this writer from Abruzzo, in Italy, is known for his antifascist novels. Was struck by how, in this novel, he describes the local peasantry’s mulish resistance to Fascism, and how Fascism uproots the traditional system of exploitation and increases the demands on the peasantry, which in turn provokes that resistence. Was struck by how he doesn’t idealize his characters. They’re not educated, they don’t have a sense of history, they’re not overly concerned with anything happening outside their little village. But they do have a strong sense of propriety–they are not there simply to be beaten down and exploited.
  • The God That Failed – Silone has an essay in this collection of six writers describing how they were attracted to and then grew disenchanted with Communism. American readers will probably be most interested in Richard Wright’s story, which is essentially about how Communist leaders kept indicting him as a bourgeois and telling him to be more in touch with Black people and to do more organizing work. Meanwhile, he’s like, I wasn’t educated past grammar school, my mother cleaned houses for a living, and I know Black people better than any of you possibly could. The real final straw is simply that they won’t give him time to write. They want to use him exclusively as an organizer and see no value in his work. His insistence on the worth of his own work is fundamentally a bit bourgeois, but I am impressed he held out against their pressure and eventually left the group over it. In general, the Communists seem almost gleeful in how they victimize intellectuals, forcing them to agree with or do all kinds of nonsensical things, until finally they’re forced to leave. One gets the sense that independent thinking itself is something they cannot stand.
  • Three Women – This nonfiction book by Lisa Taddeo got a lot of attention when it came out a few years ago. She tells the story of three women with complex sexual desires: a twenty-three year old bringing charges against the teacher she had a relationship with at seventeen (who she still, to some extent, loves); the preppy, beautiful wife who sleeps with other men at her husband’s behest; and the married woman who is emotionally sustained by an affair with her childhood flame, even though she knows he doesn’t and can’t ever love her. I identified so strongly with these stories, and the way all these women just wanted to be desired. I listened to the audiobook, which had fantastic narration. Highly recommend for anyone, but especially any woman who’s ever felt their desires were strange or off-beat.
  • Library – Stephen Akey wrote an essay in LARB recently about being a failure as a writer, so I decided to order all his books. This one is his memoir of spending thirty(ish) years working at the Brooklyn Public Library. Basically, it’s a job, not a calling. He writes about how various writers have written about their library jobs, but is most interested in Philip Larkin, who spent his career as the librarian for a rather second-rate university, and who apparently excelled at his job (reminding one a bit of how civil servant Anthony Trollope considered the penny-post to be his finest contribution to the world). Akey likes his job, as a job, it’s better than a lot of jobs, but it’s not better than writing for a living. I really enjoyed the book, even if it was a bit aimless after a while.


I probably should’ve put this first, but I am horrible at promoting my own events. I just can never believe someone would want to see with me. But I am giving a talk for San Mateo Pride called “The Queer Writer’s Guide To YA Publishing.” It’s queer-focused take on the Cynical Writer spiel I often give. Should be very good. Link to sign up

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