Division Within: Witch Hunts, Indigenous Traditions, Surveillance, and the Struggles of Trans Healthcare
The witch trials never ended — They just became digital.
Preamble
From the fires of the European witch hunts to the quiet gaze of modern surveillance technologies, the policing of bodies has been a persistent tool of governance. This essay explores the continuities between early modern efforts to demonise women’s reproductive knowledge, colonial attempts to erase indigenous traditions of gender plurality, and contemporary struggles over transgender healthcare.
At the heart of these histories lies a common logic: the demand for conformity to rigid categories of sex and gender, enforced through suspicion, medicine, and now algorithms. Where midwives once faced accusations of witchcraft, trans people today encounter psychiatric gatekeeping, tabloid scrutiny, and facial recognition systems that judge whether they “look female enough”. These mechanisms of surveillance and control do not only harm trans communities; they also discipline cis women and marginalised groups, pushing all into narrower and more medicalised forms of “acceptable” femininity.
But this is not simply a story of repression. Indigenous traditions remind us that other ways of understanding gender diversity have long existed, while contemporary research shows that affirming care improves lives and strengthens public health. The question, then, is not whether alternatives are possible, but whether societies will choose them. To affirm trans lives is to reject the repetition of witch hunts and colonial repression; it is to embrace healthcare as liberation, solidarity, and justice.
Introduction
The control of bodies has always been central to the exercise of power. Across history, what counts as “health” and “normality” has never been neutral; it is bound up with morality, religion, surveillance, and political economy. In early modern Europe, women accused of witchcraft were condemned not only for imagined pacts with the devil but also for their practical knowledge of reproduction, healing, and community care. In the twenty-first century, trans people encounter similar struggles for legitimacy, forced to prove their identities to doctors, lawmakers, and increasingly, to machines that demand conformity to rigid binaries of male and female. The parallels suggest a disturbing continuity: anxieties about gender and embodiment are persistently inscribed into systems of knowledge and control.
Yet these histories must also be understood as particular rather than universal. While Europe pursued witch hunts and pathologised women’s autonomy, many indigenous societies embraced gender plurality and valued individuals who occupied roles outside binary categories. Among Native American nations, Two-Spirit people often held spiritual or communal authority (Roscoe, 1991; Driskill et al., 2011). In South Asia, hijras were recognised in religious and social life long before British colonialism sought to repress them (Hinchy, 2019). What Europe constructed as deviance, others regarded as part of the natural diversity of human life. It was only through colonial expansion that the Western model of binary gender and medical control was imposed globally, erasing older traditions of acceptance.
This article situates the current crisis of trans healthcare within this longer, uneven history of surveillance and resistance. It argues that the demonisation of marginalised groups—first midwives, then “hysterical” women, later hijras and Two-Spirit people, and now trans communities—functions as a political technology for regulating society. At stake is not only dignity for individuals but the health of communities: evidence consistently shows that denying gender-affirming care worsens mental health outcomes and increases social costs, while affirming care alleviates burdens on systems like the NHS (Budge et al., 2013; Stonewall, 2021).
Finally, the essay explores how new technologies such as facial recognition extend these older logics into the digital age. Just as women once faced the threat of inquisitorial scrutiny, today both cis and trans women confront algorithmic systems that adjudicate whether they “look female enough” to be recognised. In tracing these continuities, the essay highlights not only the persistence of control but also the possibility of resistance: healthcare as liberation rather than surveillance, and solidarity rather than suspicion.
Witch Hunts and the Demonisation of Women’s Knowledge
The witch hunts of the fifteenth to seventeenth centuries were more than outbreaks of superstition; they were deliberate mechanisms of social discipline. Silvia Federici (2004) has argued that these persecutions were integral to the transition towards capitalist modernity. Women were targeted precisely because of their roles as healers, midwives, and keepers of community knowledge—positions that placed them outside the emerging order of male-dominated professional medicine. In this sense, the witch trials functioned as both punishment and displacement: punishment for stepping outside patriarchal authority, and displacement of authority from local, collective forms of healing to centralised, institutional control.
Accusations often revolved around reproductive knowledge. Women who used herbs to manage fertility, or who delivered babies outside clerical supervision, were recast not as healers but as murderers and devil-worshippers (Roper, 1994). Midwifery in particular was demonised; midwives were accused of smothering infants, engaging in ritual sacrifice, or conspiring with demons. These lurid accusations did more than instil fear—they delegitimised women’s authority over reproduction and justified the transfer of power to male physicians. As Ehrenreich and English (1973) note, the figure of the witch was in many cases simply the figure of the autonomous woman, punished for her knowledge and independence.
This demonisation was not confined to belief; it had material consequences. The systematic persecution of women healers helped establish the authority of university-trained male doctors, tying health to new forms of state and ecclesiastical regulation. Local knowledge, once rooted in communities, was reframed as dangerous superstition. In its place, a professionalised medical order emerged, one that would eventually become the foundation of modern biomedicine.
The echoes of this history persist. In the United States, midwifery was marginalised well into the twentieth century, overshadowed by obstetrics and denied institutional parity (Davis-Floyd & Cheyney, 2019). The medicalisation of childbirth exemplifies a wider pattern: knowledge that resists bureaucratic control is discredited, while knowledge that conforms to professional surveillance is legitimised. Yet it is crucial to note that this was not a universal trajectory. While Europe was persecuting midwives and branding women’s knowledge as demonic, many indigenous societies elsewhere developed more inclusive understandings of embodiment and healing. To see this contrast is to recognise that the rigid binaries of Western medicine were not inevitable, but historically constructed.
Beyond Witch Hunts: Indigenous Traditions and the Colonial Imposition of Gender Binaries
The persecution of witches in Europe and the demonisation of women’s knowledge was not inevitable, nor universal. While early modern Christianity constructed female autonomy as dangerous and policed sex and gender through suspicion and punishment, other cultural traditions developed alternative frameworks for understanding embodiment. Many indigenous societies embraced or tolerated gender diversity, viewing it not as pathology or deviance but as a recognised part of communal life. The rigid binary of “man” and “woman,” so central to European witch hunts and later medical gatekeeping, was not a global truth but a Western construct, later exported through colonialism.
Among numerous Native American nations, for instance, there existed long-recognised roles for Two-Spirit people—individuals who embodied both masculine and feminine traits, or who occupied distinct gender categories outside the binary. These figures often held positions of spiritual or communal significance, respected as mediators, healers, or ceremonial leaders (Roscoe, 1991; Driskill et al., 2011). Far from being persecuted, they were often integral to the cultural fabric of their communities. It was only with European colonisation, and the imposition of Christian morality and Anglo-European legal frameworks, that these identities came under attack. Missionaries and colonial officials branded Two-Spirit roles as sinful, unnatural, or criminal, erasing traditions that had long provided space for gender plurality (Morgensen, 2011).
A similar story unfolded in South Asia. The hijra community, whose history stretches back centuries in India, played visible social and spiritual roles, including blessings at births and weddings. Under Mughal rule, hijras were recognised as part of courtly and religious life. It was not until the British Raj that this community was systematically repressed. The Criminal Tribes Act of 1871 explicitly targeted hijras, classifying them as a “criminal tribe” and curtailing their freedoms (Hinchy, 2019). What had once been a recognised social category became pathologised and marginalised under the lens of Victorian morality and Western biomedicine. This shift reflected less a discovery of “truth” about gender than the imposition of colonial order.
These examples demonstrate that the strict binary of sex and gender was neither inevitable nor universal. Instead, it was historically produced within the West and violently globalised through empire, religion, and medicine. Just as witch hunts delegitimised women’s healing practices within Europe, colonial expansion exported this disciplinary logic abroad, undermining indigenous traditions of gender diversity. Recognising this history reframes contemporary struggles: the demand for trans healthcare and recognition is not a departure from “tradition” but, in many ways, a reclamation of older, pluralist ways of being that colonial modernity sought to erase.
Surveillance, Fear, and the Digital Panopticon
The colonial imposition of Western gender binaries reveals how control over bodies was not confined to Europe but was exported globally, often through a fusion of religion, medicine, and law. What witch hunts achieved within Europe—delegitimising alternative knowledges and enforcing patriarchal authority—colonialism extended across continents. This legacy matters today, because the same logics of surveillance and conformity now manifest in digital form. Where inquisitors once scrutinised women in village squares, algorithms now scan faces in airports, workplaces, and online spaces. The panopticon has not disappeared; it has been updated, translated into code, and embedded into the very technologies that claim to keep us secure.
If witch hunts represented the raw violence of repression, Foucault’s metaphor of the panopticon captures its quieter, more insidious face. In his account, the panopticon was not simply a prison design but a model of governance: a structure of constant visibility in which subjects internalise discipline even when no guard is present (Foucault, 1977). For women accused of witchcraft, the panopticon was not an abstract metaphor but a daily reality. They lived under the watchful eyes of neighbours, priests, and magistrates, where deviation from patriarchal norms—whether speaking too freely, bearing children outside wedlock, or practising healing without licence—could bring suspicion, accusation, or death. The lesson was clear: to survive, one must regulate oneself before others did.
This architecture of suspicion has not vanished; it has been digitised. Contemporary surveillance technologies extend and refine the logic of the panopticon, embedding it into everyday life through CCTV, biometric databases, and, most troublingly, facial recognition. Unlike the public spectacle of the witch trial, these new systems are often invisible, operating silently in airports, on city streets, or in dating apps. They judge without dialogue, sorting faces into rigid categories of male and female, legal and illegal, “normal” and “deviant.” For those whose bodies resist these binaries—particularly trans and non-gender-conforming people—the result is misrecognition, exclusion, or outright erasure (Melbourne Law School, 2023).
The implications are profound. As the Project on Government Oversight has shown, such technologies can aid the enforcement of anti-trans laws, providing states with tools to police bathrooms, sports participation, or healthcare access (POGO, 2023). In other words, the digital panopticon does not merely observe; it enforces. And like its early modern predecessor, it enlists ordinary people in its work: apps like L’App and Giggle mobilise facial recognition to exclude trans women from lesbian spaces, inviting users to participate in algorithmic witch hunts under the guise of “safety” (Them.us, 2023).
Crucially, this surveillance does not affect only trans people. Cis women, too, find themselves compelled to prove their sex to machines coded with masculinist assumptions. Studies reveal that darker-skinned women are far more likely to be misidentified, reflecting the racialised biases embedded in training datasets (Buolamwini & Gebru, 2018). Both cis and trans women are thus pressured into conformity: to be recognised as “legitimate,” one must embody machine-readable femininity. In this way, surveillance fosters further medicalisation and cosmetic modification—not through direct coercion, but through the quiet violence of exclusion.
The digital panopticon, then, is the modern witch trial: a system where failure to conform to a narrow archetype invites suspicion and denial of rights. Just as women once internalised patriarchal discipline to avoid accusation, women today navigate algorithmic systems that demand bodily compliance. The continuity underscores a disturbing truth: technology does not liberate us from history’s patterns of control—it often automates them.
Facial Recognition, Gender Verification, and the Medicalisation Trap
If the digital panopticon enforces conformity through constant visibility, then facial recognition is its most intimate and intrusive expression. These systems do more than identify individuals; they adjudicate identity itself. For women—cis and trans alike—this has created a new kind of witch trial, one not conducted in public squares but silently in algorithmic processes. The central question is no longer “Does she consort with the devil?” but “Does she look female enough to be verified?” The stakes, however, remain alarmingly similar: exclusion, delegitimisation, and vulnerability.
Research shows that facial recognition systems are not neutral tools. They are trained on biased datasets that reflect and reinforce gendered and racialised norms. Joy Buolamwini and Timnit Gebru (2018) famously demonstrated that commercial AI systems misclassified darker-skinned women at error rates up to 35%, compared to near-zero error for lighter-skinned men. More recent studies confirm that transgender and non-binary individuals are especially prone to misclassification because their faces do not align with binary templates coded into the algorithms (Scheuerman, Keyes & Richardson, 2020). What emerges is not objective recognition but what Cato Institute researchers call “algorithmic gender policing,” where machines enforce conformity to traditional categories (Cato Institute, 2023).
This enforcement is already being weaponised. The Melbourne Law School has documented how artificial intelligence tools are intensifying global transphobia, enabling governments to monitor, exclude, and stigmatise trans communities (Melbourne Law School, 2023). In the United States, surveillance technology has been proposed as a way to enforce so-called “bathroom bills,” demanding proof of sex before granting access (POGO, 2023). In the private sector, dating apps like L’App or Giggle use facial recognition to exclude trans women, presenting algorithmic gatekeeping as a form of safety (Them.us, 2023). These practices resonate uncannily with the witch trials: communities invited to denounce “impostors,” only now the inquisitors are machines.
The social consequences are profound. To be accepted by an app, by a border crossing, or by a government database women must present a face legible to the algorithm. This pressures both cis and trans women to conform more tightly to normative femininity. Trans women may feel compelled to pursue medical interventions not solely out of personal choice but to avoid algorithmic exclusion. Cis women, too, may be forced into cosmetic conformity when surveillance systems reject non-normative features or racialised faces. Thus, surveillance becomes a mechanism of medicalisation: the body itself is adjusted to satisfy technological scrutiny.
In this way, facial recognition technologies revive and modernise the logics of the witch hunt. Where midwives were once condemned for refusing to cede authority to male physicians, women today risk exclusion unless they cede authority to machines coded with patriarchal and binary assumptions. Both systems render women’s autonomy suspect, demanding conformity as the price of legitimacy. And in both, the outcome is the same: power consolidated not in the bodies of those scrutinised, but in the institutions that claim the right to define them.
Psychiatry, Gatekeeping, and Liberalisation’s Limits
If algorithmic surveillance represents the newest form of gender policing, psychiatric diagnosis exemplifies an older but still powerful gatekeeping system. The pathologisation of trans lives has long been embedded in Western medicine. When the American Psychiatric Association introduced “gender identity disorder” into the DSM-III in 1980, it institutionalised the idea that trans existence was not an expression of human diversity but a symptom of mental illness (Drescher, 2010). In doing so, it entrenched the logic that access to healthcare would be conditional on diagnosis: one had to be ill in order to be treated. Transition became permissible only as a form of “cure,” not as an affirmation of identity.
Activism and shifting paradigms in psychiatry eventually produced reforms. The DSM-5 (2013) replaced “gender identity disorder” with “gender dysphoria,” reframing the issue around distress rather than deviance (APA, 2013). This was an important step: it acknowledged that suffering often arises not from being trans itself but from social stigma, rejection, and the denial of medical care. Yet even this “liberal turn” carries contradictions. To access hormones or surgery in many contexts, trans people are still required to demonstrate dysphoria, to perform distress before clinicians in order to prove themselves “trans enough.” Medicalisation remains a paradox: necessary for access, but constraining in its framing.
Recent cultural battles underscore the fragility of these reforms. Trans-exclusionary feminists (TERFs), for instance, often call for the reinstatement of strict psychiatric gatekeeping or even the withdrawal of transition-related care altogether. This resonates with Foucault’s broader insight that medicine does not merely heal but disciplines, defining legitimate and illegitimate ways of being. In practice, the clinic becomes another site of surveillance: records scrutinised, bodies examined, motives questioned (Pearce, 2018). The logic of the witch trial lingers here, too—the individual must stand before authority and be judged.
The digital age compounds this situation. As facial recognition technologies demand conformity to binary appearance, and as laws in some jurisdictions weaponise medical records to deny gender recognition, the gatekeeping function of psychiatry aligns with broader systems of surveillance (Melbourne Law School, 2023; POGO, 2023). Together they produce a layered apparatus of control: doctors, bureaucrats, and algorithms each positioned as arbiters of authenticity. Liberalisation has thus far loosened, but not dismantled, this machinery. The challenge for trans liberation, as Leslie Feinberg (2013) argued, is to push beyond conditional recognition towards a politics of self-determination—where healthcare is provided not because one proves distress, but because all people have the right to live well in their own bodies.
Economics, Public Health, and the Politics of Denial
While questions of diagnosis and gatekeeping highlight the politics of legitimacy, they also obscure another crucial dimension: the economics of healthcare. Trans healthcare is often cast by opponents as an indulgence or luxury, something that diverts resources from “real” medical needs. This framing is profoundly misleading. A wealth of research shows that access to gender-affirming care significantly improves mental health outcomes, reducing depression, anxiety, and suicidality (Budge et al., 2013; Shires & Jaffee, 2015). Denial of care, conversely, forces many into cycles of crisis intervention—emergency mental health services, hospital admissions, housing insecurity—placing a far heavier burden on public resources than timely transition-related care ever would.
In publicly funded systems such as the NHS, this translates directly into questions of sustainability. Providing gender-affirming care is not only a matter of dignity but also of efficiency. Stonewall (2021) has argued that timely interventions reduce the strain on emergency services and improve long-term wellbeing, producing economic savings alongside human flourishing. When waiting lists for gender clinics stretch for years, the costs accumulate—not only for the individuals forced to endure prolonged distress but for society as a whole, which must fund the consequences of untreated suffering.
Opponents of trans healthcare often ignore these realities. In the United States, several states have introduced laws restricting or banning transition-related care for minors, often justified with religious or pseudoscientific claims about “protecting children” (Robinson, 2023). Yet these laws increase harm while also inflating social costs: young people denied care are more likely to experience depression, drop out of school, or attempt suicide, placing long-term economic and social burdens on families, communities, and welfare systems. What presents itself as moral concern is in practice both cruel and fiscally irresponsible.
Surveillance technologies intensify these pressures. As the Project on Government Oversight (2023) notes, biometric tools are increasingly considered for enforcing anti-trans laws, such as bathroom restrictions or identity verification. In such contexts, the denial of care is compounded by the active policing of bodies, ensuring that those who do not conform face social and institutional penalties. Here, too, the echoes of the witch hunt resound: the state not only withholds care but actively hunts down those deemed illegitimate.
From a public health perspective, the argument is stark. Societies that invest in affirming care reap both social and economic benefits; those that deny it pay heavily in human suffering and resource drain. The politics of denial is not only a politics of cruelty but one of waste. In the long arc of history, it repeats the old pattern: punishing those who defy rigid categories, even when such punishment undermines the community as a whole.
Conclusion
From the flames of the witch hunt to the cold gaze of the facial recognition camera, the control of bodies has remained a persistent strategy of governance. What unites these moments across centuries is not only their violence but their logic: the demand that individuals conform to rigid categories of sex, gender, and morality or else face exclusion, punishment, or erasure. The European witch trials targeted midwives and healers whose knowledge threatened patriarchal and state authority. Colonialism exported this disciplinary model globally, undermining indigenous traditions that had long embraced gender plurality. Psychiatry reframed gender variance as disorder, legitimising care only under the condition of pathology. Today, digital surveillance systems quietly extend these mechanisms, reducing the richness of human diversity to a binary legible to machines.
Yet to tell this as a story of unbroken repression would be to miss an equally important thread: resistance. Midwives defended their knowledge against inquisitors; hijras, Two-Spirit people, and other indigenous communities preserved their traditions in defiance of colonial erasure. Trans people today continue that lineage of struggle, demanding healthcare not as indulgence but as a right, and insisting that gender diversity is not a pathology but a fact of human existence. In this sense, trans liberation is not a new departure but a continuation of much older traditions of resilience and plurality (Feinberg, 2013).
The stakes are high. Denying healthcare does not preserve social order; it produces suffering, crisis, and waste. Surveillance technologies do not create safety; they exacerbate exclusion and deepen medicalisation by forcing people to mould themselves into machine-readable categories. Religious and pseudoscientific campaigns against trans rights echo the demonology of the witch hunts, dressing fear and control in the language of morality. In each case, society pays the price for its refusal to affirm difference: in human misery, in squandered resources, in diminished solidarity.
But history also shows that alternatives are possible. Indigenous traditions remind us that gender diversity has been respected and valued; public health research demonstrates that affirming care benefits individuals and communities alike; critical scholarship reveals that surveillance and medicalisation are not inevitabilities but political choices. The question, then, is not whether we can do otherwise, but whether we will.
As this article has argued, healthcare can function either as a site of control or as a means of liberation. To repeat the mistakes of witch hunts, colonial repression, and medical pathologisation is to embrace fear over flourishing. To affirm trans lives is to choose justice, compassion, and solidarity. In the UK and beyond, the choice is stark: will we continue to waste resources policing identities, or will we invest in a future where all can live well in their own bodies? History shows the cost of the former. Justice demands the latter.
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