The APA Should Rethink “Non-Binary” in New Affirming Care Guidelines
The American Psychological Association (APA) recently unveiled an important policy statement affirming evidence-based support for gender diversity across the spectrum. This includes access to critical gender-affirming interventions and protections against discrimination for transgender, gender diverse, and non-binary people. With sweeping calls for healthcare equity regardless of identity, the ambition is laudable. But in attempting an all-encompassing approach, the nuances of marginalised subgroups still slip through cracks. Namely, those occupying spaces between spaces—those identifying as non-binary.
The language raises non-binary visibility as an identity, but swiftly seems to other its viability as a state. In positioning it adjacent to “transitioning” individuals exploring fluidity, the guidelines fail to confer equal legitimacy to life lived wholly in flux. Non-binary thus implicitly remains a phase along the way to eventual binary alignment, not meriting sustained support models on its own. This absence leaves non-binary folks conceptually stranded—granted platforms for embarking upon gender journeys cut short before reaching destinations still deemed taboo.
As a non-binary autistic person possessing an intrinsic orientation to changeability dubbed “neuroqueer,” I occupy intersections at which slippages become visible. The perceptual limbo conferred by well-meaning generalisations erases the fulfilling self-ownership I experience dwelling happily within spectra. My neural wiring and emotional world intrinsically embrace variability analogous to my gender. For me and others neurocognitively inclined to shun categorisation, non-binary identity fulfills rather than precludes.
Thus in the APA proclaiming blanket backing for gender self-determination, my particular iteration still suffers exclusion. Supporting transitional states without equally upholding perpetual change leaves me abandoned. Thus I echo calls for enhancing competence among care professionals at complex intersections of neuro- and gender- diversity. No one left behind means understanding no one finds home in the binary. All gender exploration is sacred; all gender revolution holy. The shore on which I stand remains fluid, but I can still be seen.
Help against spreading misinformation
The APA policy statement declares supposed support for “addressing the spread of false information” related to gender diversity, in order to ensure non-binary well-being and dignity. Yet in outlining affirming care, the guidelines themselves propagate harmful assumptions functioning to invalidate non-binary as a fulfilling endpoint identity. Again, by primarily situating non-binary adjacently to transgender individuals “exploring” identity, language implies non-binary occupies a transitional limbo rather than a destination. It is positioned as a phase along the path to eventual binary identification, failing to equally uphold perpetual gender flux as healthy.
Though likely unintentional, this othering of variable gender occupies the same negative rhetorical space combatted elsewhere. In continually framing non-binary relative to transitional states, the document subtly casts it as temporary and abnormal. This directly contradicts the APA’s stated aim to create “public accessibility to timely and accurate information founded in clinical and psychological science.” Science supports gender spectrums as normal human diversity. Portraying fluidity as estranging relegates non-binary to a waystation en route to cis alignment. Thus in presenting themselves as gender diversity allies, the guidelines’ underlying cisnormative assumptions paradoxically propagate the “dissemination of false information” they claim to fight.
What’s the real goal here?
Upon deeper reflection, it does seem a key motivation behind the APA guidance’s focus on gender-affirming therapies and insurance coverage pertains to reimbursement systems and financial sustainability more than truly furthering provider competence or identity education.
By championing unrestricted access to clinical treatments like hormones and surgeries under the mantle of social justice, the policy statement neatly aligns gender diversity with revenue opportunities. This allows the APA to display surface-level “awareness” and “inclusion” whilst subtly entrenching medical models ripe for financial exploitation.
In essence, the emphasis on reducing barriers to medical transition streamlines pathways for insurance billing and privatised gender-identity gatekeeping. All while doing little to enrich cultural humility or counter the capitalist medical complex fueling clinical cis-normativity. Nowhere in the policy’s calls for comprehensive care do nonconformist identity education or structural change appear.
In failing to meaningfully distinguish non-binary experiences from transition trajectories, the document centres clinical binaries prime for commodification. Any threat to systemic norms is neutralised by folding gender variance into existing for-profit frameworks.
Thus the guidance tacitly upholds oppressive paradigms granting legitimacy only to identities conducive to enterprise, betraying true liberation. Fostering allyship only insofar as it enables transactions, the APA slyly confers dollars before dignity under guises of progress. But no price can be placed on self-love outside society’s strictures. This non-binary neuroqueer sees through the ploy and calls for authentic acceptance beyond any clinical constraints.