Aren Aizura’s Mobile Subjects explores the central trope of mobility in dominant narratives of gender transitions. Notions of mobility shape both macro-medical processes of global transgender health care and accounts of individual “journeys” of self-transformation. Framing his analytical work as “provincializing” the transnational flows that make transgenderism and gender reassignment culturally intelligible, Aizura critiques an understanding of trans subjectivity that is rooted in white, class-based privileges that enable, and are enabled by, exclusionary medical and social mobility. He draws attention to how the experiences of transgender people in the Global North provide the basis for medical regulatory legitimacy at the expense of non-privileged subjects, whose experiences are made unintelligible or invisible. Aizura thus provides a critical transnational materialist analysis of gender reassignment surgeries that frame transgender health care as a “commodity, a right, and a service” (p. 13) that is taken for granted by an elite few while being denied to those who are unable to embody the white middle-class ethos of respectability and self-determination.
Mobile Subjects intertwines textual interpretations of classic and lesser known transgender autobiographies and documentaries, a multi-sited ethnography of geographical mobility and its effect on trans lives, local ethnographic accounts of gender reassignment clinics in Thailand, and cultural analysis of medico–legal constructions of transgender patient subjectivity.
Writing as a queer trans man, Aizura touches on his own discontent with medical gatekeeping practices in his native Australia. He substantiates his critique by relating his experiences with a provider who first denied him treatment access and later entrapped him in a rather bizarre quid pro quo blackmail dilemma. Aizura’s and other disenfranchised voices throughout the book draw attention to the persistent power imbalance between trans health providers and consumers and to the increasing division between gender clinics composed of professional teams who collectively oversee, approve, or deny access to transition-related services, and consumer models in which patients “shop” globally for competitive “care packages” (p. 25) that suit their personal needs. This division is the ironic result of more than three decades of agitation for medical autonomy by transgender activists.
As Aizura points out, the casualties of this movement for autonomy are frequently the same people who also lose out in other neo-liberal remakings of the modern, mobile citizen. Comparing the gender transition journeys of white, privileged transgender individuals who travel for treatment from the Global North to the Global South, or from rural to urban settings, to those of less privileged transgender individuals of color, Aizura observes that transgender mobility is highly racialized and marked by socioeconomic difference. Groups of non-white transgender subjects who travel across national borders are often portrayed as “stuck” within their cultural milieu and remain tied to migrant labor or sex work, while white subjects experience no such constraints. Based on this juxtaposition, Aizura urges readers to critically rethink gendered journeys of “becoming” as products of Western, Euro American discourses on liberal individualism, in which the subject emerges heroically as the arbiter of his or her own destiny.
Aizura’s ethnographic work focuses mostly on transgender women traveling to Thailand. He examines the historical and contemporary cultural forces that have led media and surgeons alike to describe Thailand as the new “mecca” (p. 138) for transition related surgeries. He argues that orientalizing frameworks position Thailand as a feminized Other, and, in turn, feminize trans women who seek out gender reassignment surgeries there. His ethnography also highlights some contradictions. Thailand is a place that stigmatizes its own transgender population yet welcomes foreign transgender people. Such contradictions are fantasized away in the clinic by foreign patients and complicit Thai care staff engaged in affective labor. The Thai clinic works by producing and affirming critical parts of transgender women’s identity through validation, accommodation, and legitimization.
For some readers, these ethnographic sections may seem a bit lean. I would have liked to see more in-depth engagement with the social lives of the Thai caregivers who attend to transgender patients’ needs. Moreover, Aizura’s critical reading of trans autobiography and documentaries and his ethnography of Thailand’s gender reassignment industry do not connect to each other as seamlessly as his key thread of mobility might suggest. That said, the book reflects Aizura’s academic background in cultural studies, rather than anthropology. In portraying mobility as both symbolic and pragmatic means to constructing gendered subjectivity, Aizura’s work is also situated within studies of medical tourism, medical activism, and cultural critiques of biomedicine. Although the writing will be accessible to newcomers interested understanding historical and cross-cultural accounts of trans medicalization, overall, Aizura’s work favors an audience of the initiated.
To me, Aizura’s book reads as a showcase example of what I would call the “new school” of Transgender Studies. In the end, the book evokes a pondering of how Transgender Studies as a field will move itself forward. Aizura’s own urging to give a voice to transgender people who straddle the margins of privileged trans-normativity reiterates the field’s mission of breaking new paths for inclusivity, intersectionality, and independence from myopic visions of what being transgender means today.