Trans Care

Hil Malatino’s concise Trans Care begins from the care practices trans people build after repeated failures by families, healthcare systems, workplaces, and public institutions. It asks what it means for trans people to show up for one another under systemic exclusion and how mutual-aid networks, friendship, informal mentoring, knowledge exchange, and everyday accompaniment make survival possible. Rather than adding trans people to a preexisting ethics of care, Malatino argues that dominant models often presume cisgender family structures and a gendered distribution of labor. Trans experience exposes the limits of those assumptions.

The book is most powerful when it refuses to romanticize community. Care webs can be ingenious and life-sustaining, but they are also built by people who are exhausted, poor, traumatized, disabled, or themselves in need. Celebrating resilience without redistributing resources turns abandonment into a test of marginalized people’s generosity. Malatino therefore links care to burnout, bad feelings, uneven capacity, and the need for practices that are resilient without demanding inexhaustibility. This sharpens feminist care politics: care is not a feminine instinct or moral halo but material labor whose conditions, limits, and burdens must be collectively negotiated.

Across five chapters, the argument moves from surviving trans antagonism to burnout and a theory of care, then to trans history and the medical-industrial complex. The chapter framed as “hirstory lessons” treats community memory as more than an identity genealogy: histories that dominant archives have obscured can become practical knowledge passed between generations. Yet no elder or “trancestor” should have to stand in for a whole community or function as a substitute parent.

The final focus on the medical-industrial complex keeps mutual aid from becoming an excuse to outsource institutional responsibility. Sharing information, accompanying someone to an appointment, or helping navigate eligibility can close immediate gaps; none can replace affordable, autonomy-respecting care free from discrimination. Malatino’s attention to care “within and against” institutions holds both points together: clinical care matters to many people, while its rules still determine who qualifies, whose knowledge counts, and which lives receive resources.

Care here is not only a feeling but a set of repeatable practices that consume time and situated expertise: accompanying someone to an appointment, sharing institutional knowledge, responding to exhaustion, and making room for changing needs. Since capacity is uneven, a mutual-aid network can reproduce the gendered division it hopes to resist: some people become permanent organizers, translators, and crisis responders while others have room to withdraw. Malatino’s attention to burnout and bad feelings is therefore not a dismissal of community. Fatigue, resentment, and limits can signal that tasks need to be redistributed and resources secured.

This makes care a political question rather than a test of individual virtue. An idealized community is imagined as endlessly generous, conflict-free, and always available; the book instead invites readers to ask who performs administrative, emotional, and explanatory labor, and whether those tasks rotate, are compensated, or receive institutional support. That view values mutual aid without turning it into a cheap substitute expected to compensate indefinitely for institutional abandonment.

This also challenges feminist habits of naturalizing care as women’s work or treating sacrifice as proof of political commitment. By attending to who can offer support and who needs it at a given moment, Malatino makes interdependence compatible with limits: receiving care is not failure, and setting a boundary is not betrayal.

At seventy-two pages, Trans Care is a conceptual intervention rather than a comprehensive guide or empirical survey; its institutional and geographic differences need further study. Its value for readers is a precise vocabulary for asking who repairs formal systems’ damage and who pays the cost. Read it alongside Matters of Care on care ethics and Care Work: Dreaming Disability Justice on disability justice and care labor. The chapter list is available from the University of Minnesota Press, and the open Manifold edition provides the text.