Waiting Without Growth

My friend Be and I walk along Berlin’s canal, circling the same path several times, and conclude that we both feel ready to mature. English is not our first language, and therefore we are more forgiving of the incompleteness of our words (hence our acceptance of the term “mature”). We are both in our mid-thirties and have missed the possibility of dying at a heroic age—the magical rockstar twenty-seven and Jesus’s crucifixion at thirty-three now out of reach. We confess to each other, hesitant but touched, that transition has an influence on our ability to imagine a long life. All too familiar with the often-heard defense that trans care saves lives, we both refuse the idea that gender-affirming care saved us. The belief that transition has a saviorist quality just doesn’t sit right. 

Transition transitioned me. It worked on me, but not because I always wanted it and couldn’t have done without. For transitioning to stay true to its evocative character, it cannot be a stalled object or end at a fixed point. It has to be a process, provoked and influenced by what makes the process possible, and continuously malleable to its own character of change along the way. To say that transition saved my life would mean that there was something to save in the first place: a life nearing an off switch that’s now safely out of sight. Such an awaiting life requires a clear and stringent understanding of what a livable life is. Life as life, not living. 

I’m against linear time. Most trans narrators are not. Transitioning stories often start with a person’s (unhappy) childhood and are illustrated with before and after pictures. Tonal changes over time are publicly recorded (“this is my voice nine months on T”) and step-by-step plans for post-op healing or preparatory work-out regimens are shared. The leap to masculinity typically adheres to images recognized as progress—tightening hips, muscle growth, a thickening beard, a deepening voice—and claims of linear achievement.

The Healing and Aging Escalator

I’ve had surgery several times before. I’ve had injuries that were mysterious, injuries that never healed, and injuries that could return. In the past, I’ve submitted to pain and sickness and long-term wheelchair use. Now, with plastic surgery, everything was different. I went into top surgery prepared, knowing what to expect. I went in like a customer, having been told what to keep in mind, having signed waivers and forms. There was a trajectory. A timeline and speed. Having elected for surgery instead of being subjected to it because of some medical emergency, I was on a journey that started clearheaded and with a successful outcome in mind. The end goal was so preformulated that surrender was not needed. Once the surgeon did her job, I just had to do what everyone else in my situation had fulfilled. Control had been sold to me, and I had willfully bought it (my insurance paid the clinic more than $30,000). While complications could, of course, arise (the waivers warn for this!), the surgery was confidently planned. With plastic surgery like this, healing is predicted.

The first few weeks after surgery were hard. I was prepared for that, but it’s possible that all the preparation made it harder. Not materially, of course. I was very lucky to be surrounded by friends who would visit and drop off meals several times a day, help clean the house, teach me how to empty my drains, talk me through moments of confusion and pain. I had prepared a list of movies and shows to watch, but I barely did. I felt too good to give in and too fit to lay in bed. Two hours fresh out of surgery, I requested a rental wheelchair and a ride to the neighborhood bar. My partner, already plagued by chronic pain, threw her back out pushing me around, and we never touched the chair again. After a few impatient days, I could go for walks. I counted the steps on my phone and made sure to increase them a bit every day. I was badly trying to get well; bad at feeling bad. I studied the mood chart provided by San Francisco’s Gender Confirmation Center (GCC) and tracked where I was. I studied their nipple healing chart and tracked where I was. I studied their scar healing chart and tracked where I was. I stared at the list of medications I could take, but fearing constipation (which I had prepared for as well, with prunes, powdered fiber, and laxative liquids) and having grown up in the Netherlands on paracetamol and herbal tea as a cure for most ailments, I didn’t take anything more than Tylenol. 

Emotionally, however, I felt much worse than I wanted to feel. Sad and frustrated, I’d point to the mood chart and sigh in relief: only one week in, I was supposed to feel depressed. But after a short moment of relief, I went back to feeling really bad. Three weeks in, I again felt relieved, affirmed by my normative affectivity: the chart said that when things get better physically, it also becomes more difficult psychologically to follow the prescribed mobility restrictions. Knowing that I was supposed to feel bad was intellectually comforting, but emotionally it did not do shit. Tracking the trajectory of my nipples and incisions in comparison and contrast to the images on the charts did not help either. Every little bump or pain that wasn’t documented by the GCC felt like a failure. But the charts did not include the confusion about feeling phantom boobs, painful and haunting underneath my binder. Or the feeling of having been sewn up too tight, the fear of never again being able to stand upright. Of course, their charts were meant to give an estimate, a map to hold onto. But for me, they created anxiety, a constant push for comparison and competition, a sense of control that tricked me into believing that the prescribed and standardized healing journey was the only right one. As they were organized into days and weeks to describe what to expect post-surgery, I counted the hours and days and weeks, as if this calculated time would bring what was promised; as if the days were inherent deadlines. As if my fresh chest would age accordingly, not wayward and messy and full of fluid. I understand that offering a progressively mapped timeline is meant to anchor an unsettling experience while also keeping track of medical anomalies. But for me, the spelled-out timeline created an obsession, outlining a singular trajectory. I was stuck on a healing escalator.

Rapid Onset, Attuned Growth

I was lucky to be on an escalator in the first place. Many people wish to be on this escalator and are stalled for years. Luxuriously, I do not relate to the longing of so many who hope for a mastectomy from the moment their breasts start to bud. My quest for top surgery wasn’t always present: it grew once it became a possibility. The desire rose in direct alliance with my newly acquired access and coverage. Access to care lured me in, instead of having to wait for the care to come to me. Such attuned growth is what the right denounces as “Rapid Onset Gender Dysphoria,” just because we refuse to read our whole life story in line with one single desire (transition), one single disgust (dysphoria). 

For defensive reasons, I could narrate my attunement to access and care differently. I could tell you that I repressed my craving to transition until I had left the Netherlands—where trans people are made to wait several years simply to enter the centralized gender clinic, followed by a mandatory “collaboration” with a psychologist—or until I had acquired university health care in California. But if I were to call my slow surfacing desire to transition a sign of painful repression, it would require me to believe that the desire for transition is originary, contained, and static; a well-hidden treasure, unchanged by its environment, its visibility, its relationality. To believe that I was good at repressing my desire for top surgery and transition requires me to believe that such desires have a hiding place to point to. And even if I would perceive transness as such a treasure, I’d still plead to appreciate the labor that morphed these desires into a bearable weight, aligning them with what was (un)available to me. When someone comes out as gay later in life, it’s tempting to view their previous life as a lie, or at least as a period in which they couldn’t be their true self. While I take every chance to celebrate any gay life, my celebratory spirit also extends to the craft of adaptation. I’m not making an argument for assimilation (whether it concerns sexuality, gender, class, disability, race, age, or otherwise), but “not yet” out moments offer ontological suspension.1 In other words, instead of defining sexual orientation or gender identity as something that can be uncovered as a secure and stable entity, the act of adaptation—of living with the available tools, values, and interactions—suspends the ontological certainty of what we currently call sexuality or gender identity. It is this destabilization that I praise, not the conservative call for social assimilation or censorship. 

My refusal to view the process of aging as a progressive line with different life stages aimed at growing into a more “authentic” self, coincides with this desire for ontological suspension. Most conceptions of aging presume an increasingly authentic self that is discovered over time. As with transitioning, successful aging is meant to reveal a deeper sense of self. This discovery is considered positive, but it should go slow. Self-discovery is the fruit of patience, making the accepted rhythm of material scarcity seem virtuous. Care should not be presented immediately, because that would make it accessible, and care that is accessible does not have value within a capitalist system that thrives on scarcity. Because of organized abandonment, waiting is a crucial part of materializing the desire to (medically) transition.2 To receive hormones, surgery, or a name change, one is made to wait.3  

Wanting to Fuck Someone and Hoping to Age like Them

“Welcome to transgender care. Please hold the line. There are 7,000 people waiting ahead of you,” reads a flyer from the Dutch Transgender Network, addressing the exorbitant waiting times of clinics in the Netherlands. Some people wait six years before they get a first intake. Together with a group of teenagers, the trans and queer youth theater company WILD Producties put on a performance in 2022 that proposes: 

Waiting for others to be yourself, waiting for times to change. Waiting on growth and growing up. Waiting till you’re an adult, waiting for what comes when you are allowed to decide for yourself. Waiting for permission. Who waits and who determines who waits? Who has the power to make others wait? Is waiting always necessary? And what do you do while you wait?4  

What happens when you wait? You age. Those who are made to wait, inevitably age. 

The distribution of time is a way to control behavior. Gentrification not only makes life in the city unaffordable, it also increases the time that people spend commuting. The value of work is measured as productive time. Time management and time-based restrictions are strategies of capitalism and imprisonment alike. To be made to wait has obvious meaning. It delays access, it blocks people from needs and desires. In the trans context, where care is individualized, this waiting amounts to enforced aging. To deserve transition, you must age first. Young people are especially targeted, as the legal age of consent applies to them. But this concerns adults just as much. In both the Netherlands and the UK, the average waiting period for trans people over eighteen is more than five years. This waiting period is seemingly a result of scarcity, but neither the narrative of scarcity nor the imposition of waiting is innocent. In the Netherlands, for example, a mandatory bedenktijd (“time to think”) of five days was legally required for people seeking an abortion until 2023. The waiting period was installed to signal the patient’s inability to make a responsible choice. Women who make (quick) decisions aren’t framed as strong and entrepreneurial but as untrustworthy and impulsive. Barring people from quick access to trans care enforces a similar mandatory “time to think” period, but in this instance, one that lasts several years. 

Despite being narratable as a classic transgender case, whose genderbending was present at a very early age, I lost the desire to live like a boy as soon as transitioning appeared (im)possible. The possible and the impossible here closely relate: for transitioning to be presented a possibility, it has to be presented as near impossible. For gender transition to not be more widespread, it has to be contained as a very special and hard event. It cannot just happen, or always already be happening. It has to remain just possible enough for its impossibility to be profitable. This gatekeeping makes it visible as a possible and significant event, but for the event to happen, many hoops have to be jumped through. The desire to transition thrives on relational fuel, easy access, and a supportive context. That does not mean that transitioning and queerness won’t appear when these aids and tools are lacking, but scarcity and suffering should not be prerequisites for loud support. Blocking trans care might not eradicate trans people, but some of us will indeed adapt, and it is precisely this ability to assimilate that should propel us to fight for contagiously accessible trans care. Transitioning should be materially celebrated and enabled, especially if this has a contagious effect. My desire to transition grew in entanglement with availability. And so, I can say that I would have survived without gender affirmative care. I would have continued assimilating. Probably. Maybe. Perhaps. Who knows. 

Perhaps I would never have imagined growing old. But considering that I’m white and middle class with access to healthcare outside of the US, I probably would have aged anyway. This aging would have happened with the passing of time, not with an imagined horizon. My friend Be and I can now share such a horizon, while looping the same canal path in a city that’s falling apart because it privileges guilt about not stopping a previous genocide over stopping a current genocide. I do not tell Be that without Pedro Pascal’s widely celebrated daddy looks, I might still not have been able to imagine growing older. To echo the famous trans indifference between wanting to be someone and wanting to be with them: wanting to fuck someone and hoping to age like them can prove inseparable too.5 

As an impatient person—a cocktail of privilege, personality, and political conviction—I didn’t want to pick up the phone and be put on hold. I refused waiting and only cultivated my desire when care was already presented. Because I have not been made to wait, I can now imagine aging as a future prospect instead of an imposition. The waiting room is usually a mandatory subjectivation, not an invitation or stage. Having embraced age and transition as a portal to excited longevity (and who knows, with the magic of hormones, maybe one day I will look a little like Pedro Pascal), I’m now willingly performing waiting. 

I recently started visiting the waiting room of the main gender clinic in Amsterdam. This hospital clinic is internationally celebrated among health care professionals for introducing the use of puberty blockers for transgender children in the mid-1990s. Despite its appreciation in the medical field, there is a large community of trans critics who are angry at the clinic’s protocols, gatekeeping, and measured understandings of trans life. Considering the infamous waiting times and the international attention for this particular clinic, I thought it would be hard to get into the waiting room. But entry is easy. I show up, ignore the registration desk, and find a spot among those who are waiting for their appointments. Sometimes I stay for hours on end, just to be there. I sit and wait. Sometimes I overhear conversations between patients and their parents. Sometimes I witness divorced parents figuring out schedules while their child is inside with a medical professional, playing foosball, or talking about their reproductive future. Often, nothing happens. 

Sometimes I sip bad coffee, or bond with someone over the weather. Repeatedly, I read Samuel Beckett’s Waiting for Godot. I find hints of trans life in Estragon and Vladimir’s dynamic, who near damn “doll” each other as Gogo and Didi and seem to be obsessed with transition and change without ever finding a way forward or out. I scavenge the book for trans hints like these because why not enforce my own perspective onto such a canonical text that has already informed my understanding of many things—why not read back at it when it’s already been read to me? But often, nothing happens. I don’t tell anyone that I’m not waiting for a doctor, that I’m not waiting for gender. 

Strategic Overcrowding: No Appointments Involved

The standard waiting room is a white space: wipeable chairs lined up along the walls of the room, squeaky floors, near silence, walls with some decorative but inoffensive art, a plant—sometimes plastic—in the corner, a coffee machine or water fountain. But there are other kinds of waiting rooms, like the one in Buenos Aires, described by the sociologist Christoph Hanssmann, who visited the waiting room of a consultorio inclusivo, a clinic specialized in LGBTQ-related care. There, chairs are arranged in a circle and people bring dishes and snacks to share. Someone, Hanssmann writes, even celebrates their birthday.6 Trans people wait for hours and exchange. Sometimes they need care that does not relate to transitioning or gender at all, and still, they prefer to wait for this doctor instead of going to a regular GP. In Paul Preciado’s 2023 film Orlando, My Political Biography, the patients who are waiting for the doctor turn to DIY hormone exchange and erupt into a dance party. In Anna Martine Whitehead’s study of prisons in the US, the waiting room becomes a place of assembly, where the loved ones of incarcerated people check in with each other and exchange necessities for survival.7 By focusing on the waiting room instead of what lies on the other end of waiting, the experience of passing through time changes. It becomes less about reaching a next step, a next year, a next visit, a next gender. Instead, those who wait refuse the authority of the stalled in-between that the waiting room creates.  

The difference between a waiting room and a waiting list is huge. The waiting list as evoked in the Transgender Network Netherlands flyer illustrates the individualizing effect of being put on hold: without having the privilege of entering the waiting room, all you have is the imagination of 7,000 others. As an administrative abstraction, these others become competition. They are numbers that need to disappear before it is your turn. In the waiting room, it is not easy to look beyond the competitive presence of others, but it is possible. The trans person who visits the Argentinian consultorio inclusivo for regular GP care is not portrayed as taking up another person’s spot, but welcomed as a comrade.

When pressed close to other people’s stories, names, desires, smells, and erotics, it becomes possible to see the waiting room as an assembly, a space of communion. The waiting room can become a place where aging is not only a passing, a way to make it to the next, more stable, wealthier, happier, or wiser stage. Instead of creating a hold, the waiting room can hold space to celebrate, to have food, and exchange. The waiting room does not need the doctor to show up. The waiting room can be where birthdays and transitions happen, regardless of what might be satisfied next or what happened in the past. The waiting room’s collectivity inspires messing up the competitive scarcity that waiting imposes. 

Instead of not wanting to overcrowd the waiting rooms of gender care clinics, we should willingly crowd and occupy these holding spaces and not fear being left behind. This strategy of augmentation is already available to us: we can all enter the waiting room and dwell and hang out.8 The permission of an appointment or the legitimacy of a meeting is not needed. The act of waiting itself is so underappreciated that it is accessible. Institutions create the need for waiting rooms but are barely aware of what happens inside of them. The waiting room is already designed to welcome a collective sit-in. The doctor might never call anyone in, but instead of waiting to hear our names called, our collective act of dwelling can refuse the individualizing force that constructed the waiting in the first place. It’s not the waiting itself but the expected outcome that deserves upending.

Back to looping the canal. Be and I wonder aloud if our refusal to say the boring thing—that trans care saved our lives—is just another testament of individualization, hoping to differentiate ourselves from other, seemingly more normative trans folks. We see the canal, the setting sun, a line of trees—all male, causing our allergies to flare up—a group of people chilling on a bridge. We decide on another round. The view in front of us shifts with every corner we turn. What stays the same is the trash on the ground, the faded and renewed “stop the genocide” graffiti on commercial billboards. The sky changes from dusty pink to an evening blue. As long as we keep wandering side by side, we share a horizon.