Book Review:

Trans Care. Hil Malatino, University of Minnesota Press, 2020. 90 pages, $10.00 Paperback
Publisher webpage:

Review by Teresa Williams (they/them)

Michigan State University


Recommended Citation:

Williams, Teresa. (2024) “Book review: Trans Care.” Rhetoric of Health & Medicine: Vol. 7: Iss. 1.

Read below or download hereliams Book Review Corrected.


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


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 significantly. I am

familiar, through personal experience as a trans and queer person, that centering biological

family when considering care was reductive and, for many of us, not a reality.

However, I had not often considered care outside of domestic spheres. When I thought of

care, I thought of my wife caring for me when I broke my toe or taking over doing more of the

housework as I worked through a difficult depressive episode. Care for me had been something

confined within the domesticity of my home, even if that home does not conform to the

heterosexual nuclear family. But care was also when one of my cohort members sent me a

Starbucks gift card while I was completing my comprehensive exams. Care was when one of my

close friends carried our heavy air conditioners up from our basement because it made my life

easier. Care was when a colleague listened to my struggles with motivating myself to do research

and invited me to join an academic support group. These were all moments of others showing up

for me in small but meaningful ways. This was such an important realization on my end, and I

am grateful to Malatino’s book for providing that framework.

As I read Trans Care, however, I found myself thinking of how we no longer live in the

world where this book was written. The political climate Malatino wrote about has been

amplified beyond bathroom bills, becoming bills aimed to force trans people to detransition;

threaten to imprison parents and medical professionals who support trans people; criminalize

being trans, performing drag, and even simply dressing in a gender nonconforming manner in

public spaces; and demand young girls to undergo invasive inspections of their genitalia and

disclose personal reproductive health information to participate in sports. The hostility and

erasure continues to bear down on trans people, furthering burnout and exhaustion. For many of

us, our webs of care have therefore become more fragile, more strained.

Compounding this growing anti-trans cultural shift, and heavily intertwined with its

proliferation, is the ongoing COVID-19 pandemic. COVID has fundamentally altered how we

interact with one another and how we care for each other. Physical contact is no longer just a

simple act of comfort but also a potential threat to our health. In this instance, caring for

someone sick with COVID inherently puts the caregiver at risk. The public places that Malatino

argues care occurs—“the street, the car, the clinic, the community center, the classroom, the

nonprofit…” (p. 42)—now feel unsafe, especially as preventative measures are eroded even


This does not mean Malatino’s work is no longer applicable—nor does it mean that we

have no more ways to show up for each other, as Malatino calls for us to do. While physical care

in physical spaces is important, it has never been the only way to care for one another. Malatino

even describes how we can provide support outside of just physical care, specifically through

connection over social media, and the possibilities that care opens up. However, we cannot, as

Malatino emphasizes, allow the individual acts of care for survival to eclipse care as a collective

need in the pursuit of a more just society.

So, then, what happens next? What does it look like to enact, as Malatino describes it, the

“dual movement wherein we highlight the imperfection and complicity that characterizes

contemporary forms of trans care praxis as we push for collective redistribution” (p. 70)? I don’t

know. There is no simple answer that anyone can give. However, I hope this special issue and

other scholarship on the rhetoric of health and medicine can be part of solving contribute to

discussions of the nuanced, messy, and difficult work involved in care.

Author bio: Teresa (they/them) is a PhD student in the Writing, Rhetoric, and Cultures department at Michigan State University. Their research centers around professional writing pedagogy, curriculum development, and administration. Their dissertation will be surveying the current landscape of professional writing programs and the Professional and Public Writing program at MSU.