Beyond Burnout

“Voluntary Gender Workers”

Rupert Raj is a still-living trans elder, and he’s been tired. He’s been doing trans care work since 1971—the year he began to transition, at age nineteen. At the 2016 Moving Trans History Forward conference at the University of Victoria, British Columbia, Raj participated on a “Founders” panel, as one of a handful of trans movement and advocacy lifers. He summarized his experience with a not-so-brief timeline, schematizing the bulk of his life’s work as such:

From 1971 until 2002, I was a voluntary gender worker (or professional transsexual), now known as a “trans activist,” providing information, referrals, education, counseling, and peer support to transsexuals and cross-dressers and their partners and families across Canada, the US, and abroad. I also offered free education, doing training workshops, offering newsletter and magazine subscriptions on transsexualism, gender dysphoria, and gender reassignment to psychiatrists, psychologists, psychotherapists, social workers, physicians, and nurses, as well as researchers, academics, educators, students, lawyers, policy makers, and politicians.

I was struck by the occupational equivalences with which he began this description and the temporal dimension he assigned to them—his movement from “voluntary gender worker” to “professional transsexual” to “trans activist.” He claims the term “voluntary gender worker” for himself, and it’s likely that he coined it. He started a consultancy group that he dubbed Gender Worker in 1988 and ran a short-lived newsletter for “gender workers” called Gender NetWorker around the same time. Though the newsletter only lasted for two issues, the impulse behind it—to produce a resource for trans folk who found themselves doing mostly unremunerated advocacy work—speaks both to the absolutely common and widespread phenomenon of “voluntary gender work” (anecdotally, I don’t know any trans people who don’t do this work) and to the dearth of communal, institutional, and social support for such work, which makes such labor ultimately unsustainable and typically deleterious in the long-term.

It’s not surprising, then, that he began his talk with a frank admission that he’d recently taken a leave from his job as a psychotherapist at Sherbourne Health in Toronto, where he counseled trans, nonbinary, two-spirit, intersex, and gender nonconforming folks as part of Sherbourne’s comprehensive trans health program. In his own words: “I’ve been on an indefinite medical leave since last May due to, ah, work-related stress, an unhealthy workplace culture, chronic burnout, vicarious traumatization, clinical depression and generalized anxiety requiring psychotropic medication and ongoing psychotherapy.” This allied set of causes, symptoms, and manifestations, however, is not at all unfamiliar to him. Back in 1987, in an issue of Metamorphosis—a bimonthly magazine for trans men that ran from 1982 to 1988—he penned a feature editorial entitled “BURN-OUT: Unsung Heroes and Heroines in the Transgender World,” which offers up a list of fourteen trans men and women who, after many years of unpaid advocacy work, left their posts or ceased to do such work. He concludes this list with a discussion of his own experience: “I have been serving the transgender community in a variety of capacities (administrator, educator, researcher, counselor, peer supporter, local convener, public relations/liaison officer, networker, editor, writer, chairman of the Board—you name it, I’ve been it) for the past 15 1/2 years without any form of monetary remuneration whatsoever” (1987, 3).

What Raj describes is something more intense and insidious than burnout. Burnout, as a mental health diagnostic, emerges from organizational psychology literature in the late 1970s and early 1980s that was primarily concerned with decreased rates of job satisfaction and declining workplace productivity. In the classic text on the phenomenon penned by social psychologist Christina Maslach, one of the women credited with “discovering” burnout (alongside coresearcher Kathy Kelly Moore), burnout is defined as follows:

A syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do “people work” of some kind. It is a response to the chronic emotional strain of dealing extensively with other human beings, particularly when they are troubled or having problems. Thus, it can be considered one type of job stress. Although it has some of the same deleterious effects as other stress responses, what is unique about burnout is that the stress arises from the social interaction between helper and recipient. (1982, 3)

There are a number of founding assumptions worth troubling in this articulation of burnout. The first is that burnout is, specifically, a stress related to employment and thus a problem for both employers and employees to recognize and attempt to manage. Another is that it is characterized by a fundamentally bifurcated and unequal energetic exchange, where the roles of helper and recipient are clearly demarcated, hierarchical, nonfungible, and nonreciprocal—the relationships that produce burnout are not horizontal or nonhierarchical, peer-to-peer. As an extension of this logic, burnout is conceptualized as a personal—individualized—rather than a communal issue, one that affects, in particular, those in the so-called (and often feminized) helping professions. Another extension of this logic is that the cause of burnout is rooted, most often, in working with traumatized or “troubled” recipients of care and that burnout is, thus, a kind of “compassion fatigue” or vicarious trauma—not necessarily complicated by the helper’s own “troubles” or traumas.

Let me return, then, to thinking about whether or not “burnout” is the most accurate way to think about the kind of fatigue Raj describes, a fatigue that is deeply familiar to anyone who has been a “voluntary gender worker” for a significant amount of time. Historically, this kind of work is unpaid. We’re only just beginning to inhabit, for better or worse, more formalized nonprofit and institutional structures that variously—and unevenly—remunerate such labor, and the trans folks who inhabit these kinds of positions often come into them after years of unpaid hustle. Raj is a case in point, here—he got his credentials as a psychotherapist in 2001 and only then was able to make a living doing the kind of work he’d already been doing for decades, by finally legibly inserting himself within the diagnostic and treatment apparatus he’d worked for years to help build, particularly as the founder of the Foundation for the Advancement of Canadian Transsexuals (FACT, formed in 1978) and, for years, through his magazines, newsletters, consultations and trainings, and public advocacy. His experience of burnout occurs within the context of unwaged, “voluntary” labor, but what can “voluntary” possible mean in a context like the one Raj transitioned within, with no formal workplace protections, without a streamlined process to access technologies of transition or to modify gender documentation to make one’s legal identity consistent, and with the constant risk of being outed in transphobic workplaces? It is not just a problem of long hours, emotionally extractive labor, underpayment, and underappreciation—though it is, of course, most of those things. It is experiencing all of this in the absence of wages and having to engage in this kind of unwaged labor to build an ever-so-slightly habitable world for trans folks. I’ll let Raj tell it:

In fact, my preoccupation with the welfare of the transgender community is the reason why today I am without a paying career or steady source of income. Don’t get me wrong, this was my choice and mine alone (my mission or calling in life) to serve this neglected, misunderstood and, even today, stigmatized class of people—rare victims of what Kim Stuart has so aptly termed “the uninvited dilemma” [of gender dysphoria]. After all, I am a post-op F-M TS [female-to-male transsexual] myself and I guess I want to “take care of my own.” (1987, 3)

When Raj dedicated himself to networking, organizing, and advocacy on the part of trans communities, he made a decision quite counter to the standard, hegemonic medical advice given to trans folks in the 1970s, which was to go stealth, blend in, and live as normatively as possible. This was a choice, yes, but certainly not an unconstrained one. When reality is so markedly discriminatory, the advice that one should go stealth and proceed with life as if the fact that one was trans were irrelevant radically underdetermines the extent to which being trans continues to matter, even “post” transition.

In a situation of unwaged affective labor as a “voluntary gender worker,” what tools does one have to deal with burnout? There is no vacation time or “flextime” and often a scarce support network that could take over one’s responsibilities while one takes time out for self-care and healing. In the nascent days of trans advocacy and activism, it is very possible—indeed, likely—that there was no one waiting in the wings to take on the forms of unwaged labor so necessary to securing access to transition-related procedures. Who was lining up to take the reins of Metamorphosis or Gender NetWorker? Who was ready and willing to step in and become the coordinator of FACT? Given the wide geographic dispersal and extensive closeting of trans folks in the 1970s and 1980s (testified to by the fact that so many communicated through a robust network of newsletters and periodicals, punctuated by the occasional regional meet-up if one was lucky enough to live in or adjacent to a metropole), who had the time, emotional bandwidth, and energy to do this kind of work? I imagine the list was quite short.

Being a “voluntary gender worker” means you are, as Raj says, taking care of your own. This is doubly so if you are experiencing the social death and natal alienation so common to trans experiences. The boundaries between who is a carer and who is a recipient of care are pretty radically blurred in such a situation; any act of caring is simultaneously an act of maintaining those minimal networks of support that sustain you. Trans collectives and communities are deeply interwoven and interdependent, enmeshed in a way that makes distinguishing between the roles of carer and recipient difficult—they’re rotating, interchangeable, and reciprocal. Or, as that ubiquitous bumper sticker familiar to all caretakers of dogs would have it: it’s hard to know, once and for all, “who’s rescuing who.”

The language of “compassion fatigue” or “vicarious trauma” becomes challenging here. Compassion—the experience of deep sorrow or sympathy for the suffering of an other—is an inadequate affective accounting of what transpires when a community or collective is involved in acts of caring and being cared for that are informed by similar and mutually resonating forms of traumatization. Other terms utilized within the psychological literature for this phenomenon are “secondary traumatization” or “secondary traumatic stress,” which enumerate a hierarchy of traumatization that can’t possibly, in its ordinal logic, do justice to the kinds of mutual traumatic resonance that circulate between trans subjects involved in acts of caring.

The framework offered by burnout posits a discrete subject or subjects as the source of the carer’s fatigue, stress, and trauma. It encourages the person suffering burnout to causally transfer these allied negative affects to an other or others, who then become the source of the burnout that affects the subject. This denies the very basic facts of interdependency, mutuality, and subject interwovenness and encourages us to minimize the complexity of the affective interchanges at work when marginalized subjects engage in the work of making each other’s lives more possible.

How can we think beyond burnout? How can we do justice to the fact that we are often triggered by one another in the act of caring but nevertheless need one another, in both specific and abstract ways, to get by?

Three Billboards: Abstraction, Attention, Anonymity

In the summer of 2019, a billboard went up at the corner of Seven Mile and Kempa Street in Detroit; it read, simply, “Trans People Are Sacred.” The text—black handwritten centered in the top third of the billboard—floats in white space above a series of brightly colored vertical rectangles, all with rounded corners. In the center of the piece is a dusty pink arch, its ends filled in with red and capped by a black stripe with white dots. As the gaze moves from left to right, the colors shift from jewel tones to a palette dominated by light blue and pink—the colors of the trans pride flag. The height of the rounded oblongs raises toward the margins of the billboard, and tapers down in the center. They might be built spaces that form an amorphous cityscape; they might be subjects grouped tightly and reduced to chromatic abstractions; some of these shapes might be phallic, but none are brutalist or hard-edged in their monumentality. They’re gently amorphous, luminous, warm. If this is a cityscape, it is one that loves you back. If these shapes are loosely figured bodies, reduced to richly saturated auras, then this is a loving kind of minimalism that evades the economies of representation that do such violence to trans people.

It is no surprise to me that a billboard declaring the sacrality of trans existence deals in abstraction. In a context where demands on tokenized trans visibility are rife—where we are constantly being asked to show up and speak and act on behalf of our “community” (another abstraction, one that’s sometimes useful and usually fallacious)—and where such visibility relentlessly and predictably exposes one to violence, it’s a real relief to be hailed by a beautiful blob. Sometimes being trans feels like wanting to resist and evade spectacularized visibility with every fiber of your being; sometimes it feels like just wanting to be seen in all your banality, sleepily chomping on a banana while wearing sweatpants. Ever since Trap Door came out in 2018, the radical academics and cultural producers among us keep repeating the refrain that guides that book: visibility is a trap. We’re just recycling Foucault and repurposing a quip of his from Discipline and Punish—the one where he’s talking about Bentham and panopticism and he’s like y’all, to be seen is to be surveilled and to be surveilled is to be controlled and when you’re so routinely surveilled you internalize that shit and surveil yourself constantly.

The trans specificity to this has to do with the fact that we are clocked relentlessly, disproportionately surveilled and disproportionately prone to internalize such surveillance and self-surveil. When your body becomes a problem—and trans bodies are nothing if not problems, institutionally speaking—it also becomes the space where possible solutions get worked out, and this process can intensify anxieties around appearance. There is a ready and waiting medical industry that serves us in incredibly integral ways but that also makes us pay out of pocket for all sorts of procedures, even those of us who have purportedly trans-inclusive insurance, and all of these procedures aim to make us more passable, more cistypical, more reprotypical. So many trans guys with their anxieties about their height, the size of their hands and feet, anxieties that don’t seem to go away no matter how much facial hair you grow or how small and well-healed your top surgery scars are. A friend of mine over dinner, last year, as we talked about hormone blockers and The Trans Youth: “it’s wild to think that soon, there will be really tall trans guys, with big hands.” And then, for trans women: electrolysis. Voice coaching. Facial feminization surgery. For those of us with reproductive organs that work the way they are expected to work: fertility preservation, gamete freezing, the questions of orchiectomy and hysterectomy, of whether or not to cycle off hormones in order to conceive.

The problem of the body feels endless because the situations wherein it becomes a problem often seem to just go on and on: discontinuous identity documentation, the ubiquity of gender markers, the dissonance produced by the friction between these markers and our modes of appearance, “groin anomalies” as we pass through the ProVision L3, being called out of a moment of blissful forgetfulness of our embodied selves by a street harasser or a misgendering coworker. The panopticon is real, and it is gendered, and we are constantly, constantly reminded of this.

For all these reasons, many trans folks resist, both implicitly and explicitly, what photographic theorist John Tagg calls the “burden of representation” (1993) and the institutional demands for transparency, legibility, and the determinacy and continuity of identity that come with it. Passing is a fragile art, dependent on, among many other variables, the light. Flood lights are transphobic. Hypervisibility and the drive to transparency, and the technologies that enable it, are not trans-friendly. I think micha cárdenas makes this point best, in a larger meditation on the role of technologies of visibility in the lives of trans folks of color:

Passing is not simply a question of being or becoming visible or invisible, but instead a question of attaining a particular form of visibility. Often, for trans women of color, the question of passing can be determined by the amount of light and the color of light reflected from one’s face and neck. This light can determine one’s ability to survive or not, as in the case of Islan Nettles, a black trans woman who was murdered in New York after her catcaller decided that she was a trans woman. . . . Passing involves both the modulation of visibility by the person who is passing but also the reception of that image by the viewer who makes a decision about whether or not a person fits into a particular category. (2015)

Another friend of mine—a woman who made a career out of adventure sports photography and authoring guidebooks, who transitioned later in life, in a totally bro-dominated field, and has gone on to become one of the most visible trans advocates in the outdoor industry—has a quote from inspirational speaker Brené Brown tattooed on her forearm. It reads “show up and be seen.” Which is brave and inspiring when you feel afraid to leave the house, worried about coming out to lovers and friends. But also, and equally important, is the practice of learning when and how to camouflage oneself, when and how to sidestep visibility, to not be seen or to be seen only fleetingly, flittingly, in order to evade identification, to avoid being clocked. To read the light as if it’s a barometer of relative safety; to read the space and the bodies around you to gauge their potential hostility, their belligerent reactivity. This is true, too, if you’re trying to maintain a grasp on some kind of optimism during your everyday perambulations—nothing throws you out of a good mood like the unchecked transphobia of a stranger. Modulations of visibility aren’t always about life or death, but also, at some level, they are. How much shit can you metabolize and still be expected to keep on living, to keep on desiring this world?

There is also a strange anxiety induced by mainstream economies of trans representation, because most of the folks we do see are impeccably beautiful and deeply cis-passing trans women. Rarely do we see representations of folks in the midst of transition, trans guys with acne and cracked voices, whose sebaceous glands are going wild; bare-faced trans femmes who haven’t yet shaved. We are flawed, imperfect, sometimes rough in our becomings. For me, this is a kind of beauty that trumps any seamless, airbrushed art of surfaces. But the folks who actively bless our mess are few and far between.

Because of all this, there is a comfort in abstraction. Curator Ashton Cooper, in a preface to a 2016 roundtable titled “Queer Abstraction,” comments on how abstraction gets deployed “in the service of marginalized bodies to address problems of language and the complexity of subject formation in a binary world,” how a plunge into indeterminacy makes us “step outside prevailing modes of understanding both selfhood and language” (2017, 286). This describes a transsexual mood, for sure. It names the linguistic and epistemological crisis we regularly produce and also a fantasy structure of reprieve where we might, for just a moment, leave that crisis behind.

Which is precisely how I feel when I see Jonah Welch’s billboard. Anonymous, named but not represented, and hailed in the complexity of my need—to be seen and unseen simultaneously, to be comforted and also left alone, to, for once, feel held and witnessed within a public space without being made subject to other people’s witness of me. But then again, this billboard lives ephemerally, in a particular neighborhood, in a specific city, in a perennially and irrevocably cracked world. The opening of a BuzzFeed article on the project recounts, “when nonbinary trans artist Jonah Welch went to check out their gorgeous new billboard in Detroit, someone drove by and yelled ‘what the fuck’ at them” (Strapagiel 2019). Trans antagonism persists, and so do we, in all our profanity, all our banality—and our sacredness, too.

A second billboard, this one near the border of Joshua Tree and Twentynine Palms, graces the Morongo Basin of the Mojave Desert with a message, white text on a black background, that reads

TRANSGENDER PEOPLE

DESERVE

HEALTH CARE ● SUPPORT

JUSTICE ● SAFETY ● LOVE

The text is surrounded by a banner frame, rendered in blue, yellow, green, brown, beige, and red interwoven stripes that look suspiciously akin to the palette and line work of trans artist Edie Fake, who is a resident of the Morongo Basin. While we can’t attribute the board to him, we can maybe presume he helped render it. It was paid for by a group that calls themselves the Morongo Basin Neighbors, and it went up in the exact spot where a trans-baiting and trans-scapegoating political billboard used to be. In the lead-up to the 2016 election season, congressional candidate Tim Donnelly leased this big rectangle to excoriate his opponent, emblazoning it with the exhortation to “Ask Paul Cook Why He Voted To Allow Our Military Funds to Be Used for Sex-Change Surgeries!” Incumbent Cook had apparently voted, as recounted in the regional newspaper the Hi-Desert Star, “against a spending bill amendment that would have ended the Pentagon policy of providing gender-reassignment surgeries if a doctor deemed them medically necessary” (Moore 2018).

And so we move from undeserving citizen-subjects to people worthy of care, from frivolously gendered, deranged monsters on the outskirts of rights recognition draining the public coffers to a site of both lack and need. In this deeply schizoid political moment, these are the public roles available to us, altogether undeserving of care, on one side, and the demographic most in need of robust rights protection at both state and federal levels, on the other. This billboard swap is paradigmatic of the ways in which we enter into hegemonic political discourse in the current, radically bifurcated political moment—as wedge edge issue par excellence.

When the Morongo River Neighbors declare our deservingness, I’m reminded viscerally of all the shit dealt our way. I read “health care support justice safety love” as a litany of the things we currently lack, though surely, it can’t be all slow death, homicide, suicide, and sustained institutional and interpersonal violence. I, at least, have and experience “health care support justice safety love” in some significant measure—in large part because of a combination of racial, educational, and recent economic privilege—although I remember lacking in many of these categories at some point or another, with some of these points very recent. Finding myself embedded in toxic dynamics because dysphoria and a history of abuse had me convinced I was trash, thus deserving of the trash certain folks dealt. Refusing to visit medical professionals for years, although I had some form of insurance for most of that time, because I was terribly afraid of how they would respond to this intersex, trans body. Feeling like I had to be extra high-performing in graduate school because the academy hadn’t yet begun to cannibalize junior trans scholars, and I was convinced I couldn’t get away with writing about any of the things I’m currently preoccupied with and still have a successful career. Intense anxiety in public spaces and a tendency to stay indoors or alone in the woods (I mean, I still have this anxiety and I still embrace my inner curmudgeonly hermit). And I’m brutally and continually aware that this history is akin and overlapping with the bios of so many other trans folks.

Strange to be triggered by a trans-positive billboard. Strange to be triggered by public gestures of inclusion and allyship.

I’m writing this in O’Hare Airport on a brilliant fall day, staring out the big plate glass windows that make the terrible architecture of airports moderately habitable because at least you can escape to a distant horizon line. I look at the faraway silhouette of the Chicago skyline and think about the woman that checked me in at the tiny airport in State College, Pennsylvania—my current home—this morning. Approaching the counter, she sunnily sang a name for me that started with “Mr.” After scanning my ID, where my gender is marked “F,” she changed her tune to “Ms.” I told her that I don’t use either of those honorifics, at which point she stepped out from behind the counter, scanned me up and down, and proceeded to tell me how “cool” she thought that was but also how perplexing that made things for her, who had to use such honorifics as part of the corporate protocol for customer engagement. “But,” I thought, “you don’t. You could simply just not, and the odds of anyone reporting you—especially the odds of visibly gender nonconforming folks reporting you—are basically nil.” I didn’t say that, though. Instead, feeling vulnerable and sleepy and loath to engage in this silver-platter teachable moment when I was just trying to make sure I got my frequent flyer miles added to this work trip, I invoked all of the occupational privilege I have and said, “Well, I’m a doctor, so you could just use that.” She of course presumed that meant I was an MD.

What does it mean that folks so routinely internalize the injunction to perform such gendered forms of respectful solicitation by professional behest? That this kind of formalism trumps better sense, better relational intuition? Why couldn’t she just not? Why has the problem become how to more effectively slot us into preexisting institutional logics? Why are even the most radically nonreformist among us still so often ventriloquizing a thin, accommodationist rhetoric of inclusion? While the more prominent nonprofits, both trans-specific and trans-adjacent, from the NCTE to Lambda Legal and the ACLU, have been taking up the question of trans rights, there is also a small chorus of activists and intellectuals advocating for gender abolition—from built space (fuck a single-sex bathroom) to identity markers (who needs an “X” when you can just leave the whole category off) to professional sports (why are folks still advocating binary sex verification testing when we know, and have always already known, that sex itself is not binary)?

What would gender be if we abolished it at institutional, legal, and juridical levels?

Could we have it without it having us?

Would we mourn it as a kind of loss?

Would we monumentalize its absence?

When I think about loss and gender, I think about another billboard: Felix Gonzalez-Torres’s empty bed, with its two dented pillows and its rumpled sheets and its grayscale and its size, bigger than any bed I’ve slept in but not yet big enough to hold our grief. A visual parable for the AIDS epidemic, for the loss of lovers and the disruption of intimacies and the loneliness and the fear of aloneness. But also, all of the love we lose by virtue of being who we are, the abandonments, the cold beds, the lovers left and leaving who couldn’t see us correctly, who we could not adapt to, who could not adapt to us, whose desires diverged along the gendered lines we were insistent on crossing. This emptiness not just a parable but also a preamble, an opening into another form of life.

There are genders and there is Gender and I believe we can have the former without the latter. We can refuse and dismantle the structuring logic and inhabit its ruins resistantly—to be femme is nothing if it isn’t this. Some of us do and don’t survive. There are many empty beds, many missing persons, many mourned bodies. We can lose and gain genders on our way to losing Gender.

T Fleischmann, in Time is the Thing a Body Moves Through, writes about doing an art project with a friend in the woods of Tennessee, outside a cabin at one of the handful of queer communes in East Tennessee. They pulled out a big mirror and put it on a couple of workhorses and dumped out all their pills (hormones, AIDS meds) and spelled out “POST-SCARCITY.” They took photos of it, with the mirror reflecting a bluebird sky.

They did this in a moment of estrogen shortage throughout the United States, in a moment where former hedge-fund manager and CEO of Turing Pharmaceuticals raised the price of an AIDS-related medication (Daraprim, which is routinely prescribed to folks with weakened immune systems in order to treat toxoplasmosis) from $13.50 a pill to $750. The medications we rely upon to stay alive seemed to be becoming rapidly unavailable, though they were already deeply inaccessible to many—who lacked insurance, had no access to physicians, or stayed away from medical establishments out of fear of maltreatment. A postscarcity vision guides this ongoing moment where, increasingly, folks are sharing hormones, subsidizing each other’s medical care, crowdsourcing money for rent, for transition, for bail. In situations of ever-tightening austerity, dispossession, and deprivation, we cultivate methods of collective survival that aren’t just guided by an imaginary of abundance but bring such abundance to bear in the present. Which brings me back to care.