‘A Profession of Sacrifice’: Harvard Medical School Students, Administrators Grapple with Growing Personal Tolls of Medicine


Awakening the Sleeping Giant: Harvard’s Faculty Push for a Role in Governance


An Emerging Hub: How Biotech Spread to Allston


Facing A Longstanding Racial Achievement Gap, Cambridge Moves to Standardize School Curricula


Harvard’s Academic Workers Unionized. But in a Year of Labor Ups and Downs, How Did They Win?


I’m Trans, and My Gender Is a Choice. So Is Yours.


By E. Matteo Diaz, Crimson Opinion Writer
E. Matteo Diaz ’27, a Crimson Editorial editor, lives in Grays Hall. His column, “Transcriptions,” runs bi-weekly on Thursdays.

What if I told you that being transgender is a choice?

If you already feel apprehensive, I don’t blame you. Conservative actors have long leveraged similar rhetoric to delegitimize and attack the trans community. They are wrong to suggest that being trans is made-up.

But the fact remains: I chose to be trans. And every day I wake up and I choose it again.

By this I mean that, though my gender is innate and deeply-felt, I decide how to translate it into outward expression. And I’m not alone. As much as gender is a choice for trans people like myself, so too is it a choice for cisgender people, whether they are conscious of it or not.

We are all constantly making choices that impact the way others perceive and engage with our gender, from the clothes that we wear to the cut of our hair. Just because someone chooses to perform gender in alignment with their sex assigned at birth, doesn’t mean it is any less of a choice.

Framing gender this way — as a choice, rather than a fact — clarifies why the recent explosion of bans on gender-affirming care for trans youth are not just harmful but downright undemocratic: When politicians regulate gender, what they’re actually regulating is an individual’s freedom to exercise choice over their gender.

The most vocal force behind these bans — conservatives who fundamentally object to trans identity — market the legislation as a means of protecting impressionable kids from being “seduced” by “transgender ideology.” For this camp, youth are ground zero for an all-out assault on the transgender community, who they feel threaten the social order.

However, there is another, less obvious group opposing gender-affirming healthcare: Liberals and moderates whose support of trans identity is complicated by concern that youth are not developmentally mature enough to make permanent decisions about their bodies.

This second camp, though often well-meaning, lends credence to fringe or methodologically-flawed evidence that contradicts the well-established value of gender-affirming care.

I don’t question that youth are generally more impressionable and less mature than the average adult. But this doesn’t mean they must be denied access to care. And before you come at me with pitchforks, please hear my case.

First, let’s be specific about what gender-affirming care means. I’m not advocating for small children to undergo gender-affirming surgeries. Really, no one is.

In reality, medical professionals have crafted a wide menu of consensus best practices for administering gender-affirming care to youth in age-appropriate, carefully-considered ways. There is no exact, one-size-fits-all approach, but options typically range from reversible puberty blockers for younger adolescents to hormone replacement therapy to, yes, in some cases, surgery for older adolescents. Almost never are these treatments undertaken hastily or without ample informed consent.

Second, opponents of gender-affirming care fixate heavily on the possibility of regret, despite regret rates being incredibly low. Most recently, the largest survey of trans adults in the US found that more than 97 percent of respondents were more satisfied with life after receiving gender-affirming hormone treatment or gender-affirming surgery.

Of course, it is inevitable that some people will eventually regret the choice to receive gender-affirming healthcare. But absolutely universal satisfaction is a ridiculous standard. We don’t expect the many to sacrifice their personal freedom in the name of minimizing regret for the few when it comes to almost any other decision.

Choosing to receive gender-affirming care is not a far cry from choices that youth make all the time, like getting a piercing or undergoing elective cosmetic surgery. In these cases we seem to have no problem allowing youth — pending parental permission and informed consent — to make permanent changes to their bodies, even though they run the risk of regret.

Why do we treat a 16-year-old girl who wants a breast reduction so differently from a 16-year-old trans boy who wants a mastectomy? Why don’t we allow trans kids to exercise autonomy over their bodies, even under the supervision of their parents and informed medical professionals?

It is time we embrace the idea that every person has the right to exercise autonomy over their own body and self-expression, no matter who they are. By allowing trans kids to access gender-affirming care, we empower them to make the very same choices their cis peers make each and every day.

I chose to come out as trans when I was 16 years old. I didn’t choose it just because I felt uncomfortable and inauthentic living as a woman. I chose it because I have never felt more euphoric and myself than when I present as a man. I chose it because I wanted to. And every day I wake up and I want to choose it again.

It’s hard to imagine I’ll ever feel differently. But even if I did, I still wouldn’t regret choosing to be trans. The euphoria it gained me will have been enough.

E. Matteo Diaz ’27, a Crimson Editorial editor, lives in Grays Hall. His column, “Transcriptions,” runs bi-weekly on Thursdays.

Want to keep up with breaking news? Subscribe to our email newsletter.