July 15, 2025 ; Catergory: essays
The ‘born in the wrong body’ (BWB) narrative is broadly the notion that to be trans, one must have been born into a (sexed) body that is improper for them. It is an idea that was developed and utilised within the medical establishment to classify trans people (Bettcher 2014) (Bettcher 2024) (Prosser 1998). This view has largely fallen out of favour, within the medical establishment as well as within the larger trans community. Despite this, it is clear from trans people themselves that their relationship to their bodies is often integral to their experience. In a 2022 UK survey of trans people, it was noted that at least 90% of those surveyed either wanted or already had surgeries/hormones - both of which alter the body significantly (Grassian 2022). In this essay I seek to critically examine and defend the merits of the ‘born in the wrong body’ narrative. I will do so while referring to the lived experiences of trans people as a guiding methodology. I will argue that the BWB narrative does work to characterise a subset of trans people who are transsexual and who’s dysphoria stems from their bodies primarily.
In §2 I lay out my methodology and define the set of trans people we are considering in this essay. In §3 I discuss what is meant by bodies in this essay. I will do so via a critical analysis of Butler’s conception of bodies as discursive. I shall conclude that her account is not convincing and therefore that bodies are not purely discursive objects. In §4 I move to assessing BWB accounts in the literature - focusing on those outlined by Bettcher and Prosser. Through noting the weaknesses in each account, in §5 I present my own account based on Prosser that both expands his view to encompass non-binary transsexuals while defining explicitly the limits of the account’s application. In §6 I conclude.
In this section I seek to outline my methodological approach. I argue for a perspective that both privileges language use as well as centring trans perspectives. Utilising this framing I then define the term ‘trans’ as the group of people who self-label themselves as trans. Below I flesh out these commitments.
Firstly, I assert that an examination of what it means to be trans ought to privilege language use. Given that this question concerns ontology, I believe that prescriptive judgements of transness that ignore language would fail to provide an accurate picture of trans experience. Additionally, I contend that we ought to go further and privilege language use because the term derives its meaning from language use - both by those labelling themselves as trans, and by others. Therefore, if we want to understand transness we ought to defer to the use of ‘trans’ in discourse.
Secondly, I assert that given this question concerns trans ontology that we ought to approach the question from a trans philosophical perspective. A trans philosophical approach seeks to privilege trans perspectives and experiences when tackling philosophical problems - in particular, philosophical questions concerning trans people themselves (Zurn 2024). On this approach, other perspectives - such as from the medical establishment - are additionally considered but when there is a clash in claims then we privilege the view of trans people. It should additionally be noted that the ‘trans community’ - as far as it does exist - does not hold to a consensus on trans topics. Therefore, I will be explicit to note who I refer to when I speak of trans perspectives.
Given this we can provide a definition for the set of people we mean when we talk about trans people. The set of trans people is the set of people who label themselves as trans. I’ve landed on this definition because it both focuses on the language use of speakers by focusing on labels and because it centres trans people’s own perspectives on their transness - as opposed to the labelling of external groups such as the medical establishment. This understanding of transness leads us to a reformulation of the given question: how well does the ‘born in the wrong body’ (BWB) perspective classify the group of people that would identify themselves as trans? In the following sections I seek to further clarify and answer this question.
In this section I seek to elucidate what bodies are, in particular to defend the view that bodies are not purely discursive objects. To do so I will argue against Butler’s claim that bodies do not exist pre-discursively (Butler 1999) (Butler 1993). This is because if Butler’s arguments hold then one’s relationship with their body and their gender identity are purely discursive affairs. I disagree with this on the basis that it misaligns with trans experience. Below I detail Butler’s account and provide a counterargument against their claims.
First I will detail Butler’s account and arguments. Their claim is that bodies are discursive objects. That is to say that while the material parts that we claim compose a body do exist pre-discursively, the notion of the body itself is solely an idea borne out in discourse. The notion of a body comes into being through the exercise of power, in particular bodily taboos. This account of bodies stands in contrast to the traditional account found in philosophical discourse (Butler 1999 pp. 164-166) where pre-discursive material composes a pre-discursive body on which supervenes social norms derived from discourse (in this sense the pre-discursive body is intertwined with discourse rather than a product of it).
Butler supports the notion of bodies as discursive through an appeal to the work of Mary Douglas on social taboos (Butler 1999 pp. 166-167). Societies that seek to impose an order on society set out rules to prohibit transgressions and these rules get codified through the construction of bodily bounds: “[w]hat constitutes through division the “inner” and “outer” worlds of the subject is a border and boundary tenuously maintained for the purposes of social regulation and control” (Butler 1999 p. 170). Butler draws a contemporary example through the taboos surrounding homosexuality and the weaponisation of AIDS against gay communities. They draw attention to the construction of the ‘polluting person’ and the focus on AIDS as passed through boundary transgression (in this case bodily fluid). The construct of the polluted person symbolises the taboo and then in turn has the effect of regulating homosexuality within society by legitimising homophobia. Given that the bounds of bodies are constructed to societal ends, and that bounds are necessary to shape objects, bodies are concluded to be discursive.
The implications of Butler’s account concerning bodies and gender identity clash with the ways that many trans people conceptualise themselves. If the body is purely constituted by norms then that would imply that one’s relationship with their body is similarly discursive - as there is no pre-discursive body to relate with. Additionally Butler themselves draws a further conclusion that gender identity similarly could not exist pre-discursively as there is no pre-discursive inner world to host it - as the pre-discursive body does not exist: “[i]f the “inner world” no longer designates a topos, then the internal fixity of the self and, indeed, the internal locale of gender identity, become similarly suspect” (Butler 1999 p. 171). This claim clashes with the lived experiences of many trans people who attest to a very real sense of a fundamental gender identity (Prosser 1998). As an example, Prosser discusses the writings of Raymond Thompson, a trans man, on his trans experience - who discusses his strong overriding sense of his “inner identity as a male” (Prosser 1998 p. 77). As a result of this clash, I am sceptical of Butler’s account as described here and I present an argument against it below.
A strong counterargument to Butler’s conception of bodies is to point to the strength of conviction that trans people have regarding their relationships to their bodies and gender identity, which would seem puzzling on Butler’s account. Firstly, Butler claims that a given person’s relationship with their body and gender is wholly a product of discourse. Secondly, I claim that it is possible to opt into alternative discourses as claimed by Foucault in his discussion of power/knowledge regimes (Chambers 2008). If it is true that one’s relationship to their body is contingent upon a discourse, it would surely follow that a change in discourse would in turn necessitate a change in relationship. In essence then, a trans person’s relationship to their body would be malleable. However, this conclusion clashes with the lived reality of trans people. Conversion therapy aimed at trans people seeks to mend one’s dissonant relationship with their sexed body to ‘cure’ transness. If one’s relation with their body could be changed with a shift in discourse, we may assume that a conversion practice that aims to shift discourse would find success in changing one’s relation to their body. It’s clear given the trans activism against conversion therapy practices that many trans people do not find that it is possible to change one’s relationship with their body in a sufficient manner to rid themselves of their bodily dissonance. Additionally, modern medical understandings of transness also support the notion that one’s bodily relationship cannot be mended through conversion practices - given the repeated failure of conversion practices to change trans identification (WPATH et al. 2022). One’s transness therefore seems impervious to discourse changes. The fact that gender identity and bodily relation stays constant I claim is better explained by a picture of bodies that does not relegate them to mere products of discourse - but rather affirms the pre-discursive existence of bodies. Hence, I find Butler’s notion of a purely discursive body and gender identity to be implausible.
From this, we can conclude that there exists a pre-discursive body and gender identity. While one’s relationship to their body may include discursive elements, it isn’t purely constituted by it. Hence the relationship trans people have with their body may exist past the point of discourse and reside fundamentally within non-constructed ontology.
Having established what we mean when discussing bodies and trans people, I now turn to dissecting what could be meant by the phrase ‘born in the wrong body’. The use of ‘wrong’ implies that the claim is normative. There’s a judgement made towards some form of value the body has. I contend that the value in question is the appropriateness of a given body for a given individual. When it is deemed wrong, this is because it does not suffice as well as another body could have. Therefore, this implies a set of more appropriate ‘right’ bodies that would suffice. The task, therefore, for one proposing a BWB account would be to justify the normative claim.
In this section I will cover accounts given by Bettcher and Prosser. Bettcher presents a strong and weak case for BWB, as well as rebuttals to both. I support her argument against the strong case but contend that she does not disprove the weak case. I then turn to Prosser who fleshes out a type of ‘weak case’ argument and conclude that his case is compelling but limited in its applicability.
Bettcher (2014) sets out to characterise what she considers the two types of BWB accounts. Both seek to supply the normative claim by justifying the notion that one ought to have been born a different sex and hence that they ought to align their body with the correct sex. In the weak case, one is diagnosed with the medical condition of transsexuality and this condition is the reason that one ought to been born another sex. The impetus therefore is to make bodily alterations to become a man or woman. The stronger case asserts that one’s gender identity determines one’s true sex. In both cases sex is implicitly linked with a certain body that is ‘right’ for those sexed male or female. Hence the fact that one possesses a body that falls outside of this normative set provides the justification for their body being ‘wrong’.
Bettcher presents arguments against both types of narrative. For the weak case she draws an analogy between the postoperative transsexual and an individual with an XY karyotype who is morphologically female (due to complete androgen insensitivity syndrome). In the latter case it’s not clear from their body whether they are male or female. Analogically the same would hold for the postoperative transsexual. As a result, it does not seem as though they reach the ‘right’ set of bodies through transition. For the strong case she finds the notion that gender identity determines sex implausible. It’s unclear why gender identity should trump features such as primary and secondary sexual characteristics, chromosomes, and hormones when determining one’s sex. Especially given that we typically talk of sex as a characteristic of the physical body as opposed to an internal property, it’s puzzling to assert that physical facts of the body may be deemed defective in the presence of a discordant gender identity.
While I agree with her critique of the strong case, I claim that Bettcher’s attack on weak BWB fails to provide a convincing critique. The crux of her complaint is that the change does not suffice to put the postoperative transsexual into the correct body but rather leaves them in an intersexed state. However, that does not imply that the body that the postoperative transsexual has isn’t ‘more right’ for them than their old body was. The fact that their sex is ambiguous may be a better situation than when they were read unambiguously as their birth sex. Being born in the wrong body does not necessitate that transitioning puts you in the ‘right body’ and it is enough that it puts you in a better body. Therefore, I conclude that Bettcher does not provide a good case against weak BWB.
Despite this, I still contend that weak BWB does not provide strong explanatory power when justifying the normative claim. Weak BWB levies transsexuality as the explanans for the normative claim (in Bettcher’s portrayal it is specifically the medical diagnosis of transsexuality, but weak BWB does not require transsexuality to be construed medically). It’s not straightforwardly clear however what it is about transsexuality that supplies normative value on trans bodies. In the following section I critically examine Prosser’s account of transsexuality - through the lived experiences of transsexual people - to uncover how it may justify the normative claim.
Prosser’s (1998) account is - in my view - the intuitive notion of what is meant when trans people say that they were born in the wrong body. His account characterises this feeling as the dialectic between one’s self-concept within the ego and one’s embodied self. I start this sub-section with a description of his account. Then, I will assess Bettcher’s critique of Prosser’s account and argue that it fails to discredit his claim. Finally, I will front my own critique that Prosser’s account fails to provide a universal account of trans experience.
Prosser’s account relies on psychoanalytic understandings on the relationship between the body and the ego. In particular, he relies on the work of psychoanalyst Anzieu. In contrast to Butler, Prosser reasserts the importance of the body itself and does so by placing the body as essentially connected with the ego. To justify this, he relies on Anzieu’s concept of “skin ego” (Prosser 1998 p. 65), which privileges the physical skin as the underlying former of the ego. He draws attention to the fact that the “skin is the key interface between self and other, between the biological, the psychic, and the social” (Prosser 1998 p. 65) and therefore is crucial to the construction of the self. Skin ego is utilised in the transsexual picture to characterise the way the body comes to clash with the ego. The wrongness that a trans(sexual) person feels is the product of a disconnect in body image in one’s ego from the embodied reality: “I do not recognize as proper, as my property, this material surround; therefore, I must be trapped in the wrong body” (Prosser 1998 p. 77).
Notably, when Prosser discusses one’s body image he takes care to point out that it is not a visual affair, which he notes as being “normally rather feeble (it is of course absent in the blind), and normally subsidiary to the proprioceptive body-model” (Prosser 1998 p. 78). Rather, it is felt psychosomatically through “bodily sensation and proprioceptive awareness” (Bettcher 2024). To support the claim that one’s proprioceptive body-model may not map onto one’s own physical body, he discusses phantom limb experiences and bodily agnosia which both are documented examples of such a mismatch. Additionally, he notes that those affected by either of these conditions may experience great stress as a result - mirroring the stress that he claims trans(sexual) individuals experience concerning their own sexed body. As a result of this conception of trans(sexual) experience, Prosser can characterise surgical and medical intervention as restorative, as it’s restoring one’s body to one that better aligns with one’s proprioception.
In summary, Prosser claims that trans(sexuals) are characterised by a feeling of wrong-bodiedness that is captured through a clash of body image with embodied reality. He additionally claims that this is a universal feeling: “[m]y contention is that transsexuals continue to deploy the image of wrong embodiment because being trapped in the wrong body is simply what transsexuality feels like.” (Prosser 1998 p. 69). Below I outline two critiques of this account’s ability to universally capture trans experience.
Bettcher (2024) critiques Prosser by claiming that his account is too divorced from cultural demands. She notes that Prosser’s account foundationally grounds transsexuality within the body. However, one may self-identify as a given gender in a manner that involves more than just the body and includes social role. Given this, Prosser’s account fails due to being reductive and in doing so failing to give a full account of the range of trans experiences. Hence it cannot suffice to characterise transness.
I contend that Bettcher’s critique fails as Prosser’s account is not incompatible with the demands of culture. While it’s true that Prosser’s account takes the body as the foundation of dissonance, it’s important to note that one’s relation to their body is not totally immune from discourse, as discussed in §3. This is particularly relevant as contemporary patriarchal structures intertwine bodily, sexed and gendered norms. Bettcher points to trans people in contemporary society who experience social dissonance on top of a bodily dissonance to disprove Prosser, but we should expect social dissonance as a by-product of bodily dissonance. As Bettcher herself notes elsewhere, one’s gender presentation acts to implicitly disclose one’s sex (in particular genital status) and therefore the type of body one possesses (Bettcher 2014 p. 392). Given the bodily implications of social role, it should come as no surprise that one who desires a particular type of body would also want to rectify the dissonance they socially experience from others identifying their bodies otherwise. Therefore, I believe that not only is social dissonance not incompatible with Prosser’s picture, but in fact it is expected. As a result, Bettcher’s rebuttal fails to rebuke Prosser’s account.
Where I claim Prosser’s account fails is that it is not a universal characteriser of trans experience. Prosser’s account, and all BWB accounts, require that trans people have bodily dissonance and that said bodily dissonance is the foundation of their discomfort. If a trans person feels social dissonance, it must arise from a bodily dissonance. Therefore, under Prosser’s account, someone who does not experience bodily dissonance would not be trans. Additionally, someone with a bodily dissonance that arises from social dissonance would not be trans either. However, this conflicts with the experiences of many trans people (particularly within the non-binary spectrum) who do not claim to have bodily discomfort. A 2022 survey of UK trans people found that of those who identified as non-binary, 34% did not want hormones and 23% did not want surgery (Grassian 2022). Given the case of a non-binary trans person who does not want any bodily intervention, it seems to be incorrect to nonetheless characterise their transness as stemming from a bodily discomfort. To resolve this dialectical challenge between Prosser’s account and the presented example, we must either claim that trans people who do not seek bodily interventions are not trans or that Prosser’s account isn’t universal. I reject the former conclusion based on my methodology as I presuppose that those who identify as trans are in-fact trans. Therefore, I conclude that Prosser’s account is not universally applicable to all trans people.
In the previous section I critically examined existing formulations of the BWB narrative and concluded that none of the accounts provided a strong universal account of transness. In this section I aim to propose a new account for BWB, based on Prosser’s account, that applies to a particular subgroup of trans people. I claim that the BWB account succeeds in characterising trans people who fulfil both the following necessary conditions:
Below I justify the necessity and joint sufficiency of these conditions.
Firstly, I will set out my definition for transsexuality as it differs from how others such as Prosser and Bettcher use the term. To do so I will first define what sex is. I take sex to be a cluster concept (Stone 2008) which results in sex being a spectrum as opposed to a binary. A body therefore could take on multiple possible sexed configurations that would place it either closer to male, female or intersexed. Given this definition of sex, I define a transsexual person to be someone who either has made, or desires to make, some medical or surgical intervention on their body for the expressed purpose of altering their position on the sex spectrum. In contrast to other definitions of transsexuality, I do not take a change in sex to entail a binary switch between male and female. As such, my definition can capture a broader range of possible transsexual existences which would otherwise be ignored on a binary model. For example, someone who is assigned female at birth who identifies as non-binary, does not take (nor wants) hormones, but has had a double mastectomy would be included under this definition because they are altering their secondary sex characteristics and hence moving on the sex spectrum away from female to an intersexed position. Or alternatively someone who takes hormones but does not want surgeries would also count due to intervening with their endocrinology away from a binary sexed position.
This definition of transsexuality is compatible with Prosser’s account. His account does not rely on the mismatch between proprioception and body to be a binary juxtaposition between male and female bodies. It is conceivable that one’s proprioception could be for an intersexed bodily existence. With a spectrum-based view of sex, we can fit more trans people into Prosser’s picture than initially accommodated for in his own work (with his work primarily focusing on binary transsexuals) who are otherwise often erased in discussions of transsexual existence. Therefore, we can accurately group all people who make changes to their bodies as a part of their transition.
Given the above definition of transsexuality, I find that it follows quite straightforwardly that one ought to be transsexual for a BWB narrative to apply. After all, as seen with Prosser, a BWB narrative necessarily centres the body as foundational to trans experience. As noted earlier, it would be puzzling to assert that a non-transsexual’s dissonance is rooted in their body. If it were, we would expect that to manifest in the desire to make bodily alterations to remedy said dissonance. Therefore, I claim that a necessary condition for a BWB narrative to characterise one’s experience is that they are transsexual.
For the second condition, I will define what I mean by dysphoria. Dysphoria is often spoken about in medical contexts as a specific medical diagnosis. I am not referring to this when I speak of dysphoria. I define dysphoria as the discomfort that one experiences with their assigned gender, sex or body at birth. The subject of discomfort is intentionally broad to capture the many distinct ways that trans people may relate to their gender, sex, or body. The state of being afflicted with dysphoria may not be known to the person suffering under it, for example because one doesn’t know what it is like to exist without dysphoria. Dysphoria can be inferred from the euphoria that one may experience via moving towards one’s preferred gender, sex or body - that is to say that euphoria and dysphoria are two sides of the same coin. I claim that this wider definition does apply to all trans people. This is because if one does not experience discomfort with their assigned qualities (push factors away from assigned qualities) or joy pursuing their preferred qualities (pull factors towards their desired qualities) it’s difficult to explain why one would decide to make changes to their gender, sex, or body.
One may rebuke my claim by noting the mantra in many trans circles that “you do not need dysphoria to be trans”. Such a statement seems to quite straightforwardly dispute my assertion. In response, I claim that when this mantra is employed, it is utilised to push back against the medical diagnosis of dysphoria - which paints a more restrictive picture than I do - and the broader medicalisation of transness. As a result, I reject the contention that said mantra is incompatible with my own claim.
Given the above definition of dysphoria, I contend that a second necessary condition is that one’s dysphoria over their body must be their primary source of dysphoria. This follows quite straightforwardly from BWB’s placement of bodily dissonance as foundational. It would seem ill-fitting to claim that someone who felt their discomfort primarily with their gender presentation would be suffering from the foundational bodily dissonance as described by Prosser. Therefore, I affirm my contention that a BWB narrative could only apply to someone who’s dysphoria is mainly bodily. Finally, given this and the prior point - I contend that the joint fulfilment of transsexuality and primarily bodily dysphoria suffices to define the group for which the BWB narrative would characterise their experiences. This is because – as discussed in §4 – the main stumbling blocks for Prosser’s account was its necessary dependence on fundamental bodily dissonance. Both conditions presented suffice to capture the group of trans people who experience fundamental bodily dissonance and therefore would be captured by Prosser’s account.
One possible critique of my own account is that it struggles because those within the designated sub-group are unlikely to all identify with the BWB narrative. As noted in §1, the BWB narrative has largely fallen out of favour as a descriptor for trans experience and as a result it’s reasonable to expect that there exist people within the sub-group outlined that do not identify with the narrative. This presents an issue as my methodology privileges the perspectives of trans people, some of whom may disagree with my characterisation. I agree that this is a limitation of my account, but I contend that it is not a damning limitation. As discussed in §1, the BWB account developed within the medical establishment. Said medical establishment utilised BWB as the universal understanding of transness - which as discussed in §4 is incorrect. Additionally, it has historically been used to gatekeep medical access. As a result, it is expected that BWB narratives would face hostility from trans individuals given their associated history. Therefore, I contend that for those within my defined sub-group who do not subscribe to a BWB narrative it is not necessarily the case that it is on the basis that it does not resonate with them but rather may stem from the hostile history of BWB’s use in the medical establishment.
To summarise my account - I have put forward a reformulation of Prosser’s account that seeks to remedy the problems I have identified with its applicability. I have redefined what is meant by transsexual and dysphoria to paint a more inclusive picture of transness that better depicts the lived experiences of trans people. Additionally, I have highlighted explicitly the limitations of my account - that it applies only to transsexuals who primarily have bodily dysphoria and who resonate with the narrative - to not reductively characterise the experiences of trans people for which the narrative is ill-placed to justify their experiences.
In this essay I have sought to critically examine the merits and limitations of the ‘born in the wrong body’ narrative in characterising trans experience. In this section I will summarise my assessment. Firstly, I contended with Butler’s claim that bodies are discursive objects and rejected this notion based on clashing with the experiences of trans individuals. In doing so, I asserted that one’s relationship with their body may be pre-discursive and that therefore the ontology of transness may exist prior to any discourse. Secondly, I contended with existing BWB accounts. In doing so I noted the weaknesses of existing accounts in characterising trans experience - in particular noting that a BWB approach necessitates trans people to have bodily dissonance, and for this dissonance to be foundational. This is not universally felt, so I concluded that the BWB narrative is not a universal characteriser of transness. Finally, I forwarded my own account of BWB, utilising the theoretical backbone of Prosser, considering these limitations to define an account for a sub-group of trans people for which the narrative is compatible with. Notably this does leave the question of how one characterises trans people outside this sub-group unanswered. Such a formulation is out of the scope of this paper, but further discussions ought to be had to ascertain a formulation for other trans experiences.
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