Logan Smilges

This thesis investigates ways to understand transgender medicine outside the existing harmful regimentation of care mandated by biopolitical state apparatuses and capitalist pharmacology. Engaging with Paul Preciado’s Testo-Junkie as both method and foil, the thesis explores the implications of framing transition through the dual psychoses of gender dysphoria and addiction and if/how utility may be gleaned from the framing of the trans person as a drug user. While Preciado upholds the conflation of hormone use and illicit drug use as a site of revolt and possibility, I argue that this move fails to offer coherent revolutionary potential against an already corporatized and precarious order of transgender medical care. Using mixed methodology, pulling from autofiction, historiography, medical literature, and critical theory, this thesis centers on the material dependency of trans existence on un/controlled substances and explores the ways this dependency criminalizes the trans object/subject, particularly through the often-conflicting logics of addiction, care, surveillance, and pharmaceutical governance. Through case studies of anti-androgen prescription, the Drug User Liberation Front in Vancouver, and the conflicting and upheld legacies of Sylvia Rivera and Marsha P. Johnson, the thesis critiques how martyrdom and medicalization obscure trans agency and perpetuate cycles of death for intersectionally marginalized communities. Ultimately, the work critiques contemporary queer theory's retreat from persistent structural issues of trans care and its inability to meaningfully engage with the ongoing death of trans women from carceral logics and the bureaucratization of medical care. By understanding the trans person as inherently a drug user once they medically transition, I argue that any liberatory vision of trans healthcare must begin by recognizing the trans subject as an agent rather than an object. In doing so, this thesis insists that modes of counter-hegemonic trans medical care can only emerge through persistent radical undermining and reimagining of positionality, criminality, and the medical-industrial complexes which govern individuals.

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The modern settler-colonial western world has a problem with dying. This thesis considers the impact of problematising dying by proposing two models of contemporary dying that stem from a largely death-phobic culture: euphemised dying and genred dying. I extend approaches common in medical humanities to make these models of dying legible through theoretical interventions applied to the fiction of Virginia Woolf, herself a source of much work on dying and death. Euphemised dying is a rhetorical operation that camouflages deliberate acts or systems of violence by naming killings as deaths. Sarah Lochlann Jain’s living in prognosis, Jasbir K. Puar’s debility, Achille Mbembe’s necropolitics, and Michel Foucault’s biopolitics inform the construction of this violation of dying, explored through Woolf’s 'Jacob's Room' and 'Mrs Dalloway'. Genred dying is the transformation of dying into a kind of genre with conventions that can be readily controlled or managed by the dying person and/or surrounding caregivers. I call on contemporary genre studies by Fredric Jameson and Raymond Williams to examine genred dying in tandem with Woolf’s 'The Years'. Calling heavily on Stephen Jenkinson’s lifetime of work in counselling dying people and their families, this thesis argues for a reappraisal of dying as a faithful and living subjectivity or deity that deserves a place in the world, and concludes by suggesting through an analysis of 'The Waves' that we could begin to learn dying through radical practices of mourning our forgotten ancestors.

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