Book Review:
Trans Care. Hil Malatino, University of Minnesota Press, 2020. 90 pages, $10.00 Paperback
Publisher webpage: https://www.upress.umn.edu/book-division/books/trans-care
Review by Teresa Williams (they/them)
Michigan State University
will3387@msu.edu
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
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 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
further.
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.
