Trans Care by Hil Malatino (review)

Hil Malatino’s (2020) Trans Care engages in critical and necessary work to interrogate how we understand what care is and how we care for one another. In the span of 70 pages, Malatino posits an alternative way to conceive what it means to give and receive care and illustrates how care takes place within trans communities while urging us to further this praxis of care.

Malatino begins with the story of his top surgery and the aftercare from the people within his “care web,” which many trans people have developed, given how little support we often receive from biological families and society. The first chapter, “Surviving Trans Antagonism,” provides the overall trajectory of the book and dives into the political climate that works to erase trans people. Malatino ends the chapter with a relatively simple claim: trans kids deserve to grow up without having to be “already suspicious, already untrusting” or burnt out.

The second chapter, “Beyond Burnout,” considers how trans people are stretched thin in a constant cycle of caring for and being cared for, but continue to do so anyway. Malatino further explores the burnout that comes with hypervisibility, even through acts of allyship, and what sort of world might become open to us if we were to abolish gender institutionally and legally. The chapter ends by ruminating on “post-scarcity” in relation to the medical needs of trans people, how we come together for collective survival, and how those methods of survival relate to the concept of care.

The third chapter, “Theorizing Trans Care,” discusses how trans people alter understandings of gender, calling into question the hierarchy and “natural” structure of family dynamics. This disturbs how the labor of care through domesticity within households/families has been centered in previous feminist work. Most importantly, Malatino argues that though we understand care to be labor, we also should avoid understanding care through the neoliberal lens of an “equal exchange.” Care cannot be construed as debt that must be repaid because care cannot be measured, nor should we try to measure it.

In the fourth chapter of “Something Other Than Transcestors: Hirstory Lessons,” Malatino describes how diving into queer and trans archives became another strategy for Malatino to cope with such hostility. However, Malatino also grapples with an ethical duty that comes with caring for trans archives—respecting the lives of the people represented in those archives who we can never truly know, even as we try to tell their stories. He ends by contending that we should not think of the trans people represented in archives as “transcestors” but instead consider how they are deeply connected to our current existence.

The final chapter of the book is “Trans Care Within and Against the Medical-Industrial Complex,” and it considers the ways that medical institutions have historically failed and continue to fail to care for trans people. Malatino argues that if the medical field does not support us, then we must support each other, highlighting how Wwe crowdfund for surgeries and hormone therapy, provide advice on navigating fraught medical situations, and ultimately comfort each other. However, to truly enact care means to focus also on meeting needs collectively and not only individually—particularly when which individuals receive care is often rooted in and can perpetuate existing inequities and injustices. Malatino ends the book with a call to acknowledge what we owe each other: to show up however we can and to care for one another, and that doing so habitually and instinctively will push us to reject a world that does not.

Analysis: What Comes Next?

Trans Care is a pivotal work in the rhetoric of health and medicine that complicates our understanding of care work and community. Within our work, we must not uphold exclusionary framings of care, especially to answer the call of this special issue to focus on queer and trans communities. Malatino provides just one path to shifting that mindset.

My own thoughts on what care is and how to enact it have grown...