This article analyzes how trans health was negotiated on the margins of psychiatry from the late 1970s and early 1980s. In this period, a new model of medical transition was established for trans people in Norway. Psychiatrists and other medical doctors as well as psychologists and social workers with a special interest and training in social medicine created a new diagnostic and therapeutic regime in which the social aspects of transitioning took center stage. The article situates this regime in a long Norwegian tradition of social medicine, including the important political role of social medicine in the creation of the postwar welfare state and its scope of addressing and changing the societal structures involved in disease. By using archival material, medical records and oral history interviews with former patients and health professionals, I demonstrate how social aspects not only underpinned diagnostic evaluations but were an integral component of the entire therapeutic regime. Sex reassignment became an integrative way of imagining and practicing psychiatry as social medicine. The article specifically unpacks the social element of these diagnostic and therapeutic approaches in trans medicine. Because the locus of intervention and treatment remained the individual, an approach with subversive potential ended up reproducing the norms that caused illness in the first place: “the social” became a conformist tool to help the patient integrate, adjust to and transform the pathology-producing forces of society.

本文分析了从 1970 年代末到 1980 年代初，跨性别健康是如何在精神病学边缘进行谈判的。在此期间，挪威为跨性别者建立了一种新的医疗过渡模式。精神科医生和其他医生以及对社会医学有特殊兴趣和培训的心理学家和社会工作者创造了一种新的诊断和治疗制度，其中过渡的社会方面占据了中心位置。本文将这一制度置于挪威悠久的社会医学传统中，包括社会医学在创建战后福利国家中的重要政治作用及其解决和改变与疾病有关的社会结构的范围。通过使用档案材料、医疗记录和对前患者和卫生专业人员的口述历史访谈，我展示了社会方面如何不仅支持诊断评估，而且是整个治疗方案的一个组成部分。变性成为一种将精神病学想象和实践为社会医学的综合方式。这篇文章专门揭示了这些跨医学诊断和治疗方法的社会因素。由于干预和治疗的中心仍然是个人，因此一种具有颠覆性潜力的方法最终再现了最初导致疾病的规范：“社会”成为帮助患者整合、适应和转变病理的顺从工具——社会的生产力量。变性成为一种将精神病学想象和实践为社会医学的综合方式。这篇文章专门揭示了这些跨医学诊断和治疗方法的社会因素。由于干预和治疗的中心仍然是个人，因此一种具有颠覆性潜力的方法最终再现了最初导致疾病的规范：“社会”成为帮助患者整合、适应和转变病理的顺从工具——社会的生产力量。变性成为一种将精神病学想象和实践为社会医学的综合方式。这篇文章专门揭示了这些跨医学诊断和治疗方法的社会因素。由于干预和治疗的中心仍然是个人，因此一种具有颠覆性潜力的方法最终再现了最初导致疾病的规范：“社会”成为帮助患者整合、适应和转变病理的顺从工具——社会的生产力量。