Thus, I need to write my thoughts down. As usual, I hope the exercise will help me clarify my own (somewhat unstable) position and test it in the real world. With a big amount of luck, it might also be useful to some of my readers.
I cannot doubt my own pain. When I feel it, the feeling is what warrants my claim of being in pain. When someone else denies it, the only way I can possibly understand their denial is that they imply I’m lying. If they were right, two possibilities would exist: I’m lying, or I mistakenly believe to be in pain.
Denying someone else’s pain is to call them liars or deluded. There is no escape from this, apparently simple conclusion, is there? I don’t think so, but nevertheless, denying someone else’s pain is something that happens all the time, in medical settings, even.
Hang on, surely I’m overstating my case, right? Doctors are there to help, and if a patient comes in, claiming they are in pain, they will take her seriously and do everything they can to help. Right? Right?
Many women know it is wrong. The case of endometriosis makes it glaringly obvious and is well documented. As reported by Huntington and Gilmour already in 2005 “The time period between initially seeking medical help to a diagnosis being made typically took 5–10 years” or even:
Characteristically, diagnosis was a time of relief […] after years of having experiences negated by medical authorities and being told the pain was a normal part of menstruation. Women’s feelings that their pain was being dismissed as imaginary have also been noted in other studies
Or take the reports collected by Elaine Denny as far back as 2004:
The same survey reports that over half the respondents felt that their general practitioner (GP) did not take their symptoms seriously
Here is the crucial point: endometriosis is common. About 10% of women suffer from it. And yet, according to Morassutto et al. (2016), it’s quite possible that about 6 out of 10 cases still goes undiagnosed.
Endometriosis is a very common and debilitating illness; nevertheless it is still trivialised and dismissed on a regular basis. So long for Evidence-Informed Medicine. But it doesn’t end there, you can pick pretty much any pathology that disproportionally affects women and find similar patterns: misdiagnosis, lack of understanding, dismissal, mistreatments (do I need to mention the sorry business of the infamous vaginal mesh?).
Right, why is this happening? Most likely, because medicine still is a male-dominated field. Blokes can’t empathise with menstrual pain, not very well, at least. When presented with difficult cases of chronic pain that they can’t even begin to imagine, trivialising and/or normalising it presents a relatively easy escape route for the practitioner; as a result, too many might pick it.
The fact that doing so puts the patient in an unmanageable psychological situation does not prevent this kind of error: the patient ends up having to accept the authoritative conclusion (your pain is normal, not a concern) while being unable to do so (the pain is real and debilitating). It’s an insufferable injury: adds psychological distress of the worst kind on top of chronic pain, and nevertheless happens all the time.
Going back to my starting point: my pain, when present, is undeniable. Like ‘Cogito ergo sum‘, it is not up for discussion. Why? Because it happens in my mind, and as such, it has a genuine essence. My own description of such essence is: perceived pain is a physical sensation that comes with an avoidance imperative. The essence of pain is that it comes with the desire to make it stop. This makes it a special phenomenon: when it happens to us, it’s one of the few things of which we can (at least sometimes) be absolutely sure.
Nevertheless, doubting someone else’s pain is common practice – in fact, denying the undeniable, simply because it happens in someone else’s mind, generates much unnecessary suffering.
Some time ago I wrote a essay where I claim that physical things don’t have an essence, only concepts do. Our cognitive structure generates the illusion that the concept “Tiger” picks up something objective: the ‘essence’ of Tigerness. But in the real world, there is no such thing. There is no point in time when the “Tiger” species started to exist, not objectively – when a tiger dies, there is no objectively identifiable point in time where it ceases to be a tiger. We can be sure that 2+2=4, as it’s a completely abstract claim (the elements thereof admit precise definitions, because they do have an essence), but claiming that a given creature is, objectively, a “Tiger” is, if taken literally, nonsensical. To make such a claim meaningful, we need to do extra work: such claims can be understood to mean that the vast majority of able-minded humans will recognise the creature in question as an instance of the concept “tiger”…
All claims involving physical things should be understood in such a way. This is important: since such considerations apply to all claims of a certain kind, in common practice we can productively shortcut the whole thing, stop making the distinction between concept and instance thereof, forget all this malarkey and just talk. In fact, we do. We forget the distinction and by forgetting it, we create huge problems.
Here is one: right now, there is a fight consuming two communities which would (actually: should) otherwise be ‘natural allies’. Trans-Rights activists clash with other Feminists in a fight that has become nasty and the cause of much suffering. I want to propose that, much like the doctor dismissing pain caused by endometriosis, the clash in question is caused by the common confusion on how and when something has an essence, as opposed to when such an essence should instead be recognised as a useful (shorthand) fiction.
Let’s start from a Trans Woman. She self identifies as a woman, but her physical appearance is such that, seeing her, the vast majority of able-minded humans will recognise the person in question as an instance of the concept “man”. Like the case of pain, her feeling of being a woman is something that happens in her mind; negating it can have only two implications: she’s either delusional or lying. Like the case of pain, her feeling isn’t questionable: she feels like a woman because she feels like a woman. The feeling is not something she can change, and when she says “my essence is womanhood”, every single reply of the “No, it is not” sort comes with the “You are lying” implication. The “delusion” implication doesn’t or shouldn’t really work, because our woman knows for a fact how she feels. The result is nasty: all such reactions are either accusations of bad-faith or of mental-illness, and accusations that ultimately negate the legitimacy of feelings which, from within, are unquestionable. How would you react? With a strong defensive reaction, that’s how. Such “No, it is not” responses are inevitably psychologically and existentially threatening.
It should be obvious, but alas, it isn’t. Why? Because the vast majority of able humans will (instantly and automatically) recognise the person in question as an instance of the concept “man”. Thus, the automatic and uncontrollable (most common) reaction gets erroneously equated with “objective reality”. You will hear/read things like “this person is biologically male, and that’s a fact“, or “the intricacies of sex-biology are irrelevant, he has a penis, therefore he’s a man“. Here is the news: such claims are not only wrong, they are catastrophically wrong. They cause unnecessary pain and are plain stupid. For starters, the intricacies of sex-biology are relevant beyond reasonable doubt. Mismatches between anatomy, genetic material, self image, sexual orientation and development are common – whoever claims to care about “facts” should start by acknowledging them. Moreover, if you are affected by any one of those intricacies of sex-biology, they will probably define a huge part of your existence; anyone claiming they are irrelevant is claiming “you are irrelevant”. It is cruel, without any counterbalancing benefit, and also manifestly false: nobody is irrelevant to herself. Finally, it is counter-productive: when the stated aim is to eliminate systematic oppression (which is why I consider myself a feminist), negating the very existence of people who are very visibly subject to systematic oppression doesn’t quite facilitate reaching the stated objective.
(1) A claim such as “I self-identify as a woman” refers to the concept of womanhood. Since it refers to a concept, there are situations where it can be asserted with absolute certainty. [Therefore, it is acceptable to negate such claims only if and when one has strong reasons to believe that who makes them is deliberately lying.]
(2) Claims such as: “this person has a penis, therefore he’s a man“, refer to objective reality and as such should always be understood as approximations – they imply an essence, which is a useful shortcut, but does not exist outside our own minds.
It is a counter-intuitive reversal, but I find it extremely useful, essential(!), even.
It follows that using (2) to rebuke (1) does not work. You can’t negate (1) without implying that it is a delusion or a wilful lie. Claim (2) is irrelevant to (1) as it refers to a separate domain. It is also ineffective, as claim (2) (properly understood) is inherently weaker than claim (1).
Oh. So why does it happen? Because my main argument cuts both ways, that’s why. If you are an outspoken feminist, invested into actively trying to reduce the systematic oppression of women, chances are you probably have been afflicted by an endless stream of unpleasant, threatening and perhaps physically damaging interactions with men. Thus, when confronted with a person who you immediately and automatically recognise as a man, you probably wouldn’t see a natural ally, you’d see a potential threat.
Responding, fine, but *this* particular person self-identifies as a woman, so your feeling is wrong and should be ignored, is stupid and harmful, pretty much as objection (2) is harmful to Trans people. If somebody feels pain, they are in pain. If somebody feels like a woman, they are a woman (to themselves). If someone feels threatened, they feel threatened.
How this translates in actual situations does matter. For example, Trans activists would like sport activities to be organised following self-identification and not by claims about (non existent) objective biology. I have (personally) little doubt: their argument looks logically unassailable. If you self-identify as a woman, you’d like to share the dressing room with other women and would feel out of place when competing against men. Moreover, if you dress, behave and actively try to look like a woman, frequenting male dressing rooms is likely to be genuinely dangerous, I dare anybody with half a brain to deny it.
But other women see (inevitably perceive) you as a man, and some would (objectively!) feel threatened if you were to use their same dressing room; many would also feel disadvantaged when competing against you. Moreover, asking them to ignore their (actual, real and well identified) feelings and act as if they didn’t exist, is a form of oppression, which gets justifiably and predictably resisted.
It is not clear to me how to solve such problems, but one thing can be said: deploying arguments of the type exemplified by (2) is harmful and ineffective – no matter who they are aimed at. Calling someone a TERF when they use arguments like (2) is, consequently, formally correct, but at the same time, it is also harmful, because it reinforces the (justified) negative reactions which created the problem at hand. In my view, both approaches (calling someone a TERF, as well as being a TERF) are afflicted by the same source of error: we mistake what we perceive as real with reality itself – we need to, in order to function, but we should be very aware of how and when it can cause problems.
I see no universal antidote, but a general rule of thumb does apply: compassion works. It really is that simple. One needs to start by acknowledging the reality of the other person’s feelings – failing to do so inevitably generates new enemies, it creates more problems, without solving any.
All this is quite depressing, even if it rests on an absurdly optimistic assumption. So far, I’ve constructed my argument as if we could take it for granted that all claims made were sincere. That’s not always the case. All people lie, sometimes.
In the case of Trans people Vs (some) Radical Feminists, a common objection to the Trans-rights requests is that predatory males might exploit any system based on “self-identification”, to prey-on, or otherwise harm women (4). If it can happen, given enough chances, eventually it will, making this argument non-dismissable. Conversely, we know that Trans people are regularly harassed and harmed when no weight is granted to self-identification claims (5). Unfortunately this situation is pretty much the status-quo, thus, arguments of type (4) cannot legitimately be used to stop attempts to change the status-quo based on (5). However, considerations based on (4) can and should be taken into account when discussing how to change the current arrangements.
I do not wish to claim that such problems are easily solved, far from it, but I can propose an interim conclusion: starting from a compassionate stance does make such horribly difficult problems a little bit more tractable. Or, in negative form: trying to address such problems without starting from a compassionate stance, makes the problem harder, because it inevitably creates a conflict (or exacerbates the pre-existing one).
Does this depend on the ratio between honest and deceitful claims of type (1)? In the case of Trans Women, self identifying as such comes with such an obvious and terrible cost, that one would be inclined to think that very few men would consistently self-identify as women for predatory (or otherwise unsavoury) reasons. However, in cases where we can expect many people to wilfully misrepresent their perceptions, the situation might change. Does this invalidate my claim about the need for compassion? I don’t think so.
One such case applies to the row about Antisemitism within the British Labour Party. According to many, Labour has a problem with Antisemitism, a problem which the Party has consistently failed to address, even if, undeniably, a vast amount of words were spent trying to do just that. Many people, including me, are convinced that lots of accusations of Antisemitism have been hurled in bad faith: political opponents of Labour abound (naturally) and even within Labour, factions opposed to the current leadership have a clear reason to hurl (possibly untrue, but very damaging) accusations. It’s politics, you should expect all sorts of foul play.
Does this mean that Labour does not have a problem with Antisemitism? Nope. It would mean so if and only if, all accusations were lies. The existence of any self-identified Jew who felt threatened by some Labour policy or the utterances of some Labour officials makes the problem real. Anyone claiming that “Labour does not have a problem with Antisemitism” is either lying or a failing to apply due compassion.
Personally, I could produce, on command, a number of claims, knowing full well that:
(a) I’d be saying things I believe to be true,
(b) I do not intend them as Antisemitic,
(c) I can detect no trace of Antisemitism in my whole being, but,
(d) they will be perceived as Antisemitic by a non-negligible number of people.
This is the case because what “Antisemitic” means is different to different people – even if something does have an essence, we still can’t be sure it is the same essence for everyone! To a non-Jew, white bloke, like myself, Antisemitism means some things, to a Jew, it necessarily means much, much more. Thus, compassion: one should sometimes shut up and listen. Ask what is perceived as Antisemitic and why, learn the nuances, and only then venture in the delicate business of making claims you believe to be true, if you really must.
The crux remains the same: if hearing an utterance makes you feel threatened, I have no right to say that it doesn’t or shouldn’t. Whether it shouldn’t is irrelevant, because it does. Nobody has control over their immediate emotional responses, in the same way in which when I see someone with a penis I inevitably see them as men. Thus, refusing to acknowledge the perceived threat is precisely what didn’t work with respect to the whole Labour Antisemitism row. Responding claiming innocence, on the basis of (a,b,c) and/or the alleged bad-faith of some players, is wrong and harmful. That’s because arguments of this sort are arguments of type (2): they negate the undeniable. If one is in pain, nothing anyone can tell them will convince her of the contrary. Claiming that “Attacking Israel isn’t Antisemitic” or that “One can denounce Zionism as a racist ideology without being Antisemitic” negates the reality of the effects that such claims do have on real people. It does not work, it harms both parties, it is utterly stupid because the lack of compassion makes the problem harder to solve. It’s a way to manufacture new enemies, instead of facilitating the creation of a shared understanding.
Importantly, all this works even if lots of people willingly deploy the Antisemitism card exclusively for their own political aims. Given that we have reasons to believe that lots of people do feel threatened and that this feeling does impact their capacity of participating in the activities of the Party, the presence of liars does not remove the requirement for compassion.
In conclusion, I argue that claims involving one’s own feelings refer to mental states, therefore they have an essence. Having an essence frequently allows such claims to be accurate and undeniable (with the exception of lies), which is why, when tackling these problems, a compassionate stance is necessary. Denying such claims, when they are sincere, can frequently imply an (objectively?!) existential threat to the claimant. This fact inevitably generates a confrontational reaction. Thus, if the aim is to solve the problem at hand, such denials are usually extremely harmful and should be avoided at all costs.
Now go out there and be nice to one another, that’s an order.
Notes and Bibliography
I wish to thank Abeba Birhane for her support, inspiration and for providing useful feedback on this article.
 Note that I’m explicitly referring to my own best effort to describe the essence of (my own) pain. The fact that my pain has an essence doesn’t automatically mean I can accurately describe it in words; more importantly, it doesn’t mean that I can safely assume that such essence is shared between me and all other human beings. In fact, I’m pretty sure that different people feel pain in different ways…
 If you think this is too abstract and complicated, a typical case of philosophical nonsense, then I urge you to keep reading. If I’m right (big if), this stuff matters and has important implications on how we live and for everyone’s well-being.
 My learned readers might wonder why I’ve decided to avoid referring to the distinction between sex and gender. I did, because the intuition it fosters is the opposite of what I’m promoting. If something is seen as “socially constructed” many (automatically and immediately) feel that it makes this something “less real”. Which is the central problem I’m trying to address, so I will steer away from a framing that is likely to backfire (in the case of this present essay).
 Yes, really, even if it’s hard to pinpoint precise numbers. We’re talking about stuff you can see and touch in the real world: it doesn’t have an essence and therefore you can’t objectively pin it down. Moreover, nobody can claim to know how biological factors influence mental ones, apart from knowing that they obviously do have some influence. To get an idea of the prevalence, we can look at estimates of anatomical abnormalities, which according to Lee et al. (2015) are not uncommon at all: “When all congenital genital anomalies are considered, including cryptorchidism and hypospadias, the rate may be as high as 1: 200 to 1: 300“.
 The case of Trans Rights could indeed be used to discuss other common and harmful mechanisms. First of all, given a well defined problem, most people would expect that it is possible and desirable to identify a set of rules that define the correct way to solve it. This might explain why reactions such as (2) are so common, despite being wrong. Some problems can’t be solved, some others should not be solved, and some don’t admit one single set of rules that apply to all cases. Moreover, the sub-problem regarding Trans Women in professional Sport is plagued by additional issues. Sport, as commonly practised, benefits from competition as a stimulus to keep improving. Professional Sport is different: competition, winning and losing is what generates money. This makes the sub-problem different from the common one (the one that applies to Sport as leisure) and should therefore be treated separately (I’d also like to add that part of the problem is precisely how we tend to give too much importance to winning and losing).
 I regard this point as crucial, because it requires people to make a counter-intuitive inversion. Claims about things that don’t have an essence (the actual stuff out there in the world) should be understood as less certain than claims regarding one’s own mental states. Which produces a bit of a mess with respect to the concept of ‘objectivity’, but that’s another story…
Denny, E., 2004. Women’s experience of endometriosis. Journal of advanced nursing, 46(6), pp.641-648.
Huntington, A. and Gilmour, J.A., 2005. A life shaped by pain: women and endometriosis. Journal of clinical nursing, 14(9), pp.1124-1132.
Lee, P.A., Nordenström, A., Houk, C.P., Ahmed, S.F., Auchus, R., Baratz, A., Dalke, K.B., Liao, L.M., Lin-Su, K., Looijenga 3rd, L.H. and Mazur, T., 2016. Global disorders of sex development update since 2006: perceptions, approach and care. Hormone research in paediatrics, 85(3), pp.158-180.
Morassutto, C., Monasta, L., Ricci, G., Barbone, F. and Ronfani, L., 2016. Incidence and estimated prevalence of endometriosis and adenomyosis in Northeast Italy: a data linkage study. PloS one, 11(4), p.e0154227.