Gender is a socially constructed identity that is imposed upon people from the moment they are born based on their biological sex. It clusters human males with a set of traits that include strength, courage, independence, violence, assertiveness, restricted emotions, sex disconnected from intimacy, pursuit of achievement and status, self-reliance, strength and aggression. It clusters females with traits that include gentleness, empathy, sensitivity, caring, sweetness, compassion, tolerance, nurturance, deference, dependence, weakness and need for connection.
One does not need to strain one's critical thinking capacity to see how "gender" is a set of stereotypes that advantages one group over the other and is the foundation for the global exploitation of females by males.
It would be wonderful if trans theory and experience actually dismantled these stereotypes, allowing all people to dress and behave outside of these assigned gender roles without stigma. It would be great if the trans movement resulted in a decrease in the social tolerance for male violence. It does neither.
(to be continued)
21
Not wishing to cause offence to, or disrespect any person diagnosed with gender dysphoria, but I’d say it is a mental disorder. Not is the sense that it’s wrong to feel like you should have the body of the opposite sex but in the sense that feeling you’re trapped in the wrong body causes such distress and anguish that the person struggles to lead a normal life. The only options to alleviate the symptoms seem to me to be 1. Therapy so the person can learn to cope existing in a body they don’t consider to match their gender. 2. Gender reassignment surgery. Being gay myself difference is that I don’t feel like I require either of the above to lead a normal happy life. Btw I’m referring only to those with gender dysphoria, not those who consider themselves gender fluid.
8
Before the separation into male and female sexes occurred in evolution, biological reproduction perforce had to be asexual. As a thought experiment, had humans existed before that differentiation took place, they would have all been hermaphrodites, and the first appearance of two separate sexes would have undoubtedly been as hard to understand, and thus accept, just as so many find it hard to understand and accept homosexuals, bi- and transsexuals today.
A relic of the DNA that governed the original androgynous state of our evolutionary antecedents to a degree undoubtedly still exists as part of our genomic makeup, but which in the vast majority of cases remains recessive, unexpressed, and thus not manifested in the phenotype, i.e., ones actual observed properties, morphology, development, or behavior, in the vast majority of us.
But that DNA in a certain number of births may get expressed, such that a fluid variety of sex and gender characteristics should be possible to understand and be expected, that is, to all who don't reject evolution outright.
1
I am a member of the T community. When I was 4 years old I asked my mother "was a mistake made, am I supposed to be a girl."
I didn't speak about it again until I was 53 and my life became unlivable. In the past 3 years my life has taken such a change and not the change I expected.
In late 2015 I was a complete and total mental wreck. After 50 years of struggling with the "I should have been a girl" issue it was all I thought about. My work suffered, my personal life suffered, my relationships suffered and I was an angry human being.
In the last three years I've been on Estrogen and Anti-Androgen medication and I'm amazed at the difference. I NEVER think about my gender any more. All the noise in my head has gone away. I'm a much happier person and I'm at the top of my game in all aspects of my life.
Obviously there is a LONG story here but my point is, I knew at age 4 that something was wrong. I lived with anguish and desire for 50 years. Is that right? Is that what some people want?
Outside of the immediate family of someone who transitions it doesn't affect anyone. One of my guiding thoughts during the last three years was "No body cares. If someone does care they are a No body."
If you have never met and spoken with someone who is transgender you might be surprised to learn that we are people just like your neighbor who is Left Handed (Research how in the 1920's being left handed was removed from the mental disorders list!)
15
All I know is this: My friends who are trans who have started or made their transitions are happier and living more authentically than they were before, and I can feel their lightness and optimism radiating outward each time we get together.
2
American society is moving awfully fast on this issue, and I too pause because children are involved.
Identifying as gay or lesbian can be undone. But we are talking about medical treatments, powerful drugs, surgeries -- things that cannot be undone. And we are bringing children, young children, into this. It has become a cultural moment.
What if, in some respects, that is all it is? Questions about mass psychology come to mind. How much are young minds shaped by this new world we live in? Are we wise in asking 11 year olds to "know" their sexuality or gender identity?
I am not a specialist. I am not a member of the community in question. I am not a parent in the middle.
But children are involved, and I am suspicious about how fast moving this issue is. Are we perhaps getting our children involved in adult debates too much? I just have questions, and concerns, and I do not think they are misplaced. Again, because children are being involved and drawn in to this.
Will we some day see a lawsuit from an adult against their parents, claiming that the parents improperly granted consent to powerful medical alterations to their body before they, themselves, really was old enough to truly know what was what?
137
@pjc I'm certain that the author of this piece--or any credible professional--argues that children should be given hormone treatments or reassignment surgery. You're putting up some straw arguments here.
9
I am like you on that I do not belong to the LGBTQ community and I do not even have children. However, I have volunteered with at-risk children. Some of these kids struggle with transgender issues, primarily stemming from how society treats them. If you do not know anyone or any families facing these issues, get to know them. It will transform how you look at these issues.
10
@pjc I think 11 year olds are pretty cognizant of their sex and gender identity. I have an almost 10 year old, and there's pretty much no doubt in his mind or anyone else's that he's a total guy. No one questions his sense in defining himself. If an otherwise happy kid DOES think their body and brains are mismatched, why do we immediately pretend they are too young to know?
6
70-80% percent of children who show signs of identifying with the sex not their own end up identifying with their biological sex (Steensma, 2013). New research out of Brown University indicates that 30-40% of high school and up people claiming to be transgender are the subjects of "Rapid Onset Gender Dysphoria." If these two research findings do not indicate a psychological phenomena that can indicate distress, the issue is with the reader and not the research.
https://www.sciencedaily.com/releases/2018/08/180822150809.htm
25
Mr. Grinker, like many people with little knowledge of the DSM, overlooks a very important issue.
It is not being transgender that is the mental disorder. It is the distress and interference in functioning that occurs in some people who identify as such which is the issue. People who are comfortable with whatever sexual identity they choose do not have a mental disorder and do not need any treatment.
Without the presence of a diagnosis, those who are distressed by their gender identity could not get the professional help they may need.
Sadly, many people overlook the importance of the symptoms causing significant distress and impairment in functioning the presence of which are required in making the diagnoses of most mental disorders (the rare exceptions are when the behavior harms others such as child molesters and arsonists).
This is why you often read the falsehood that everyone fits the diagnosis of at least one mental disorder which, if this were true, would mean that essentially no one would be able to function properly and the world would collapse.
5
The arguments about the DSM are true, that many, especially those of the religious reich persuasion, use that to argue that trans people can be 'cured' (of course, by using 'reversion' therapy that works so well on gay folks, basically telling them God hates them and hitting them with the bible to cure them). It is also true that the argument for having it in there was to allow trans folks to get treatment paid for, the problem is of course that insurance companies routinely still claim it is 'unproven' or 'experimental' or worse, 'cosmetic surgery', and the Christian slime balls in this country through our glorious apartheid government, have made sure no laws will be written mandating coverage (ACA for example specifically excluded care for trans people as part of the mandatory coverage, because the Catholic Bishops and the evangelical christians demanded it).
The problem with classifying it as part of sexual health is that the conservatives will argue then that this is catering to a sexual fetish (remember, for most Christians, Muslims and Orthodox Jews sex is a magic word; use it, and they are against it). I would suggest it be treated the way a birth defect is, like if someone has a cleft palate, undescended testicles, bones not growing fast enough, etc, and have it as a medical treatement, rather than anything to do with psychology or psychiatry.
3
@bill d. The birth-defect analogy is a good one. The best available science suggests that gender-identity inversions and ambiguities result from prenatal hormonal anomalies, which, of course, neither mother nor fetus, know about or have any conscious ability to respond. It appears to be a matter of how specific parts of the brain get wired.
Harry Benjamin formulated it perfectly in the 1960s. If it's in the brain, and we don't know how to change the brain, can we change the body and alleviate the dysphoria, however imperfect the result?
2
@DMC Please site the research that has investigated the womb environment and measured hormone levels on a fetus. How many wombs were used? It is a theory and NO available science suggests anything even close.
2
you talk in headline like a mental disorder is a bad thing. dis order is da best one
4
The comments are predictably depressing. Xenophobia runs awfully deep in American culture, whether it's fear of foreigners or fear of possibilities for which there is scant to zero evidence.
Anyone who experiences being trans, or loving someone who does, can explain that it's hardly a choice, let alone a fad or misguided liberal parenting concept. It's just that it is so rare, and so discordant with the lived experience of that vast, non-trans majority, whether straight, L, B, T or Q, that it seems to bring up all manner of rational questions and irrational figments of hyperactive imaginations.
If you think no one is born this way, or that it's just something to address with conventional mental-health therapies, consider the one great real-life experiment that was tragically conducted by a well-meaning but ultimately wrong early psychiatric expert, Dr. John Money at Johns Hopkins.
A baby boy suffered a circumcision accident that severed his penis irreparably. A decision was made to reassign him as a girl and test the "nurture" theory of trans etiology, that we learn to view ourselves as male or female through childhood training and experience. Suitable chemical and surgical treatments followed into adolescence. Then, his innate male gender identity reared its head and asserted itself as an unambivalent male persona. By the time he reached his late twenties, he took his own life, hopelessly conflicted by the circumstances of his life.
It's not a fad or delusion.
4
@DMC I meant to say L, B, G, or Q, the T being today's topic. I wish the NYT had the WaPo's edit window.
@DMC So your example shows one thing only - using surgery, you cannot alter the truth of the fundamental chromosomal makeup of a person. That's what trans skeptics like myself have thought for a long time. Odd, because you appear to believe that your example shows the validity of trans. Not so.
9
Wanting to cut off your penis or breasts is not a sign of someone who is mentally healthy.
52
adults can do what they want, no matter how odd. But children must be protected. No child should be encouraged to pursue transgender treatment.
39
There are no medical interventions for children, save hormone blockers, which can be undone at any time. Once a child goes through puberty, their identity becomes more distressing, so blocking hormones is a way to avoid that while living as their preferred gender. Surgical interventions do not occur until after age 18, and only after the individual has been through years of therapy and cleared by psychologists and other medical professionals. None of this happens on whim or without the individual’s express consent.
To wrap up, “treatment” for children means respecting their identity and nothing more.
3
Psychiatrists consider some other non-pathologies to be pathological, too. For example, grief.
1
Not true. Although there is debate over what is considered pathological or complicated grief, it is not the same as "regular" grief. For example, one of the criteria for complicated grief is inability to function after an extended period, e.g. even 6 months after a loved one's desth.
4
You contend that trans is not a mental disorder because someone's inability to "abide the sex they were assigned at birth" did not result from anything they or anyone did wrong. That's like saying schizophrenia is not a mental disorder because according to many it is the result of genes, chemical defects and physical abnormality in the brain. Whatever the cause, both schizophrenia and being trans primarily affect one's behavior as opposed to one's physical characteristics. Of course, as you point out, characterizing trans as a physical health issue provides for the possibility of insurance coverage of hormone therapy and gender-affirming surgeries. So this is really about money.
33
@Jay Orchard Physicians who do the alterations get paid huge huge money for these surgeries. If the transgender is in the army, the US government pays for the surgeries.
4
@Jay Orchard. No. It's really about health.
I think it’s fairly clear that something has often gone awry during the early development of someone who is transgender. I don’t know if science has determined whether it might be physical, perhaps caused by exposure to hormones in the mother’s womb, or is emotional and the result of environment. Maybe it is both or either. There do seem to be co-morbid mental health diagnoses and I’ve heard some anecdotes that suggest a higher number of people with autism also decide they are transgender. A label may or may not be helpful here. There are people who are transgender who should be able to live and work and receive appropriate medical care. How society will go about ensuring those rights without trampling on the rights of others who might object to sharing a locker room or being pressured to use a certain pronoun has yet to be decided. On the other hand, I would not go out of my way to allow minors to undergo physical alterations or take medication. Surely there is something suspect if a young teen decides out of the blue that they must be transgender and that kid just happens to have a group of friends who also decide suddenly that they are transgender and none have shown previous signs of being transgender. I would not permit such a child to “socially transition” without appropriate care from a very careful psychiatrist.
18
@Bookworm8571 This is caused during fetal development in the mother's womb. Genitals form in the first 5-12 wks, the brain finishes at 20 wks w/gender ID area. Parents who throw their kid out for opting to be authentic to their brain, are responsible for what happens in the womb. Kind of ironic. I've been around schools, and these kids do not consider trans to be trendy. SMH
The current climate is a toxic one for teens. The notion of "gender fluidity", which is garbage, is producing more confusion. The notion of "transgender", which is a fiction, further confuses these impressionable youth. The transgender activists have an incentive to convince more that their gender-role confusions (which all of us have) are really transgender ideas. Numbers are political power.
We should push back against transgender lies. 90% of children who believe they are transgender before puberty revert to biological sex after. By not forcing and supporting transgender confusion, more kids will be helped. Transgender identification leads to an unfulfilled life, and is for most a complete fabrication.
54
crazy time....another reason why Trump won the election....anybody remember bathroom! Bathroom! Bathroom! For a few months there in 2015 that was the nation's hot topic - beings with penes wanting to go in the girls' room. Dominated the news for months. Now we've got the Donald. Let's move on.
12
So much agree. Have often said was the bathroom debate really worth getting this president....
Homosexuals perceive themselves for what they are—persons sexually attracted to members of their own sex. Homosexuals don’t believe there is anything “wrong” with them. Their problem is bigotry and prejudice against homosexuals.
Transgender individuals perceive themselves as something which they are not—members of the other sex. Transgender individuals know there is something “wrong.” There are not delusional; they are aware of the incongruence between their perception of themselves as male or female and their actual sex. While they also have to cope with bigotry and prejudice, this incongruity between their gender identity and actual sex is the prime source of their discontent. Males strive to become female and female strive to become male without success because humans are not among the species that can change sex. The results for many is chronic depression and high rates of suicide. Some even have their sexual organs removed and replaced with replica genitalia.
This is why thy APA correctly teats gender dysphoria as a psychiatric problem. It is no longer listed as a disorder out of political correctness, but the diagnosis is the same as when it was called “gender identify disorder.”
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@William Case
"Transgender individuals perceive themselves as something which they are not—members of the other sex"
Unluckily, you're misinformed as i was on the argument. While your pitch on homosexual is partial, >(they perceive their body as theirs, the difference is in their sexual preference), in the case of transgender there is a no-xx choice, they perceive their body has wrong, and they perceive the gender, the noun and the meaning behind it, as wrong, that's why they, better say some trans activists fiercely advocate for gender fluidity, that is the end of gender as notion, they don't want to be woman male-born, or viceversa, that's why there's an escalating number of pronouns around trans community of activists (70 by some count), because, you know what else was coming out... the denial of sex and throw in also the denial of body as sexual defined, that's why in the trans community there are people who identify with fairies, yes fairies, and asexual, and people who identify with their animal of preference. It's chaos in displaying.
I think they took the trans as a state-word instead of a stage-word, freezing the process from happening, which explains the highlighting on the gender "fluidity".
3
@Alex
If men could become women and women could become men, there would be no transgender issue, would there?
Advocacy for gender fluidity has zero affect on anyone's sex. Sex ins't fluid, Humans are not among the species that can change sex.
21
Homosexuals perceive themselves for what they are—persons sexually attracted to members of their own sex. Transgender individuals perceive themselves as something which they are not—members of the other sex. Homosexuals don’t believe there is anything “wrong” with them. Their problem is bigotry and prejudice against homosexuals.
Transgender individuals know there is something “wrong.” There are not delusional; they are aware of the incongruence between their perception of themselves as male or female and their actual sex. While they also have to cope with bigotry and prejudice, this incongruity between their gender identity and actual sex is the prime source of their discontent. Males strive to become female and female strive to become male without success because humans are not among the species that can change sex. The results for many is chronic depression and high rates of suicide. Some even have their sexual organs removed and replaced with replica genitalia.
This is why thy APA correctly teats gender dysphoria as a psychiatric. It is no longer listed as a disorder out of political correctness, but the diagnosis is the same as when it was called “gender identify disorder.”
12
Whatever people's self-image of sexuality is, I don't see how surgical modifications of their sexual organs will produce orgasms comparable to those of unmodified genitalia. Exchanging a real penis for a surgical vagina probably won't make the patient happy, as one subject wrote in this newspaper recently. In terms of "First, do no harm" such surgeries are arguably unjustifiable.
39
It is important to have some kind of diagnosis, simply in order for transgender people to receive the medical treatment they need. But there should be a simple, nonjudgmental diagnosis, in the way that near-sighted simply says that the patient needs glasses.
8
@Cathy It's important to have a diagnosis so that the psychological infrastructure has more grist for its mill (hey, we're all sick and need 'therapy') and so that a proper billing code can be generated.
1
@richard I'm not talking about psychological treatment but medical treatment, like hormone therapy, "top", and "bottom" surgeries. These procedures are very expensive and should be covered by health insurance when they are needed. There are other supplemental procedures that can be very expensive, like laser hair removal for transgender women. They enable people who happen to be transgender to live normal lives like everyone else.
The amount of misinformation in this comment section is outstanding. I completely agree with the author of this article that removing "gender dysphoria" from the DSM is a crucial step in advancing the rights of transgender individuals. One of the big things I see people conflate is sex and gender. Sex in and of itself only refers to the genitals that we are born with, and, as pointed out in the article, even that notion can be muddled when the concept of intersex comes into play. Individuals who are intersex have a variety of genital and chromosomal combinations that put them outside of the realm of binary sex, combinations I might add that occur naturally. Gender on the other hand is the way we present ourselves to the world. That is why someone who is transgender may present to the world as a certain gender that might not match with our view of what that person's sex should be. No one should care what someone has in their pants!
8
@Patryk - but THEY're the ones who care about what's in their pants and want to cut it off! You're a man who wants to feel feminine? Go ahead and wear makeup and a dress, no one cares. But once you start taking hormones and chopping off your genitals, then you're mentally ill.
18
But doesn't sex re-assignment surgery proves that sex and genitalia indeed matters when it comes to gender ? If it were true that gender and sex are separate and independent, nobody should feel the need to have one to be the gender they feel/ think they are.
4
Yes, I can’t quite figure out why it matters unless you’re planning to have sex with someone. Otherwise, unless we’re planning to, say, systematically discriminate against one sex or the other, what should any of us care what someone does or doesn’t have in their pants. Treat everyone equally and as they choose to be treated.
2
About 1.5% of human children are born "intersex", meaning the person's sex organs are neither fully male nor fully female. This is a biological fact. When we talk about "gender reassignment", you are actually talking about the person's biological sex, not her or his gender. And it's only "reassignment" in the sense that an attending physician normally has to assign a newborn as a "male" or "female" at birth, even if the newborn is neither.
However, denying facts is what ideology/religion is all about. Although psychiatry is considered to be an area of medical science, I have never much believed in psychiatry. It has way too much ideology. Now I have even less reason to believe in psychiatry.
5
@Jay David -that is a false statistic. it is more like 1 out of 2000 children are born with ambiguous sex organs.
6
@Jay David I think you could write to the character limit and still not demonstrate a distinction between sex and gender.
Transgender and intersex are not the same thing. Intersex children have genitalia from both sexes and generally a three-part chromosome, i.e., XXY (or other combinations) vs. XX (female) or XY (male), etc. They will usually determine their gender preference in their early development stages and will have surgery to remove one set. Transgender people usually know around that same time that their biological sex and their genitalia don't match the gender they predominantly identify with but they do not have both genitalia or the extra chromosome. At least that's my understanding of these very complex biological development issues.
Can anyone with scientific or medical understanding of the issues explain why Gender Dysphoria isn't simply a special case, or subset, of Body Dysmorphic Disorder???
Except that Gender Dysphoria specifically concerns reproductive organs I fail to see any differences. The anxiety, depression, and feeling that the body differs from the brain's perception of what the body should be seem to be all the same, no???
21
Do not believe “Body Dysmorphic Disorder” is a real organic “disorder” either. Its the medicalization of being unhappy with one’s appearance, and a completely different phenomena than trans.
1
@Nirrin Gender Dysphoria is a result of being born with genitals that do not match the brain's gender ID area. There are also being found areas in the brain related to body perception and movement. Genital form early in womb, brain around 20wks. So if one is born say female, with the wrong genitals, the brain is sending signals in subtle ways that this is not the correct body form, even movement! Inter-sex children know their gender ID also. Surgery is put off, as doing it might do nothing to help them. I am retired healthcare professional of 35 yr career. HTH
So, just to be clear, if it is not a mental condition or problem to believe that is one is ”in” the “wrong” sexed body, then at what point does it become not an issue to be paid for by insurance because it is cosmetic, like wanting larger or smaller breasts, which is not covered by insurance? Indeed, the new trend in the trans culture seems to be to not have surgery or use hormones, or even to change dress, but merely to “identify as” the other sex, keeping the old genitalia intact, and that does not require any medical expenditures at all.
18
Plenty of adult human females “cannot abide by” the norms of the sex they were **observed** to be at birth. Such incongruence results from patriarchy and misogyny, among other factors.
It is degrading to women to suggest (or state) that we accept our oppression as a “social identity.”
So, right, women who dislike our indoctrination into patriarchy and a woman-hating social order do not have “woman dysphoria.”
Therefore the comparison to “African-American dysphoria” is a red herring — either bad faith or woefully incompetent.
Finally, many if not most intersex activists object vociferously to such efforts to use them as pawns to put forth the fantasy that gender is a matter of identification rather than socialization based on categorization acccording to dimorphism sex class.
The invocation of different cultures is also dubious, but one could take such examples as genuine inspiration rather than cheap justification: make up (or better yet, *discover*) additional identities, but don’t cannibalize my experience in patriarchy. What we have in common is not wanting to “abide by” oppressive gender roles based on sex class — *not* a mythic, ineffable, and equally oppressive, “social identity.”
24
Who's paying for the medical treatments and the post-surgical illnesses?
I don't want to pay for any of this. Not in my taxes, and not in my already-high insurance premiums.
Do you?
25
@znlgznlg. And if you do not have the perfectly healthy diet and are not exercising responsibly who’s paying for your medical treatment? I don’t want to pay for it with my taxes or increased insurance premiums.
6
It's an interesting question how the concept of disorder should be defined, but I don't think it should be driven by political considerations. I don't find it plausible that homosexuality is a mental disorder, but it does seem plausible to me that a condition in which a person feels profoundly uncomfortable with their own body, or feels that it is wrong for them or does not correspond with who they are, is a mental disorder.
If there is a meaningful answer to this question, I don't think we're going to get it from an anthropologist who just wants to say that everything is relative to a culture.
17
@Mark We're sure not going to get it from conclusionary reasoning either.
Cultural responses--often based on religious dogmas negative or positive--are not cogent arguments to use in approaching transgenderism.
Our mammalian species is naturally fruitful via binary sexual reproduction. As with any other system of protein transcription and cell reproduction, glitches can and do occur. Many of those glitches may be harmless but some are errors large and small. Heart defects occur naturally; that doesn't mean we don't attempt to repair them. Intersex individuals occur naturally; that doesn't reduce their full humanity but it does interfere with their ability to reproduce. There's a biological spectrum between XX and XY; all of us fall somewhere on it naturally, but that doesn't mean everyone, no matter where they fall, is both physically and mentally healthy no matter where they fall.
If you don't have a biological anomaly rendering your apparent biological sex incorrect with what you believe yourself to be, then it's pretty likely you are struggling with a mental/emotional disorder, and trying to make your discordant parts match may cause further harm. The trans community is pretty militant these days in shutting down voices not adhering to the current party line, so it's hard for people who regret the interventions they've undergone to freely express themselves.
As with any mental disorder--the sufferer often proclaims most vociferously that he or she is just fine. Social movements shouldn't drive healthcare diagnoses/treatments.
29
Just because psychiatrists have the classification of gender dysphoria doesn't mean everyone who identifies as transgender is automatically diagnosed with the condition.
In fact, most transgender people do not undergo gender reassignment surgery, and many don't even take hormones. For many, social transition is enough -- they don't meet criteria for gender dysphoria. Other transgender people, however, are so distressed by their body that they need to transition surgically as well.
The diagnosis of gender dysphoria simply helps distinguish transgender people who need significant medical and surgical intervention from those who need little to none. It seems like a useful distinction to make.
6
@Anne
According to the Diagnostic and Statistical Manual of Mental Disorders, “In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning. It lasts at least six months and is shown by at least two of the following:
A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
A strong desire to be rid of one’s primary and/or secondary sex characteristics
A strong desire for the primary and/or secondary sex characteristics of the other gender
A strong desire to be of the other gender
A strong desire to be treated as the other gender
A strong conviction that one has the typical feelings and reactions of the other gender
1
@William Case
The key phrase is "and significant distress or problems functioning."
The criteria for gender dysphoria includes not only being transgender but also failing to cope with being transgender.
Being transgender itself is not the psychiatric diagnosis.
I think Mr. Grinker has confused this in his essay.
1
Trying to to clarify what is meant by "mental disorder" (as opposed to a physical disorder) will never work, at least for very long. It will always be in flux as our culture changes as it is now.
Your biological gender may be obvious but your mental gender is not and no amount of neuroscience can define how a person feels. Consciousness is way too much of mystery, Mr. Grinker.
2
"Being Trans Is Not a Mental Disorder"
So you say. But to convince many of us, you need to craft arguments & provide evidence. Just repeating the same assertions over & over again isn't good enough.
79
@curiousme The article was about the professional politics of the DSM-type handbooks, not the underlying scientific issues, evidence, or debates. The Internet awaits if you sincerely want to understand and evaluate the various positions.
3
@DMC That's the problem with the article. Its a column by an anthropologist, not a medical doctor or biologist, discussing a biological & scientific issue entirely in terms of politics.
Science is science, politics are politics. Look no further than today's GOP and climate change to see what happens when you politicize something that's scientific.
32
@curiousme Do you think that medical associations make things up, or do you think that there is underlying research?
The DSM is clearly a political document. But, to be fair so is the critique of it, especially in terms of a trans activist agenda. Mental illness can be explored and thought about in many ways. Something could be considered abnormal simply because it doesn't fit in with social norms, and power structures can and have been at times used to enforce those norms. In a liberal democracy, at least when we are consistent, we try to limit this to things that can harm someone. Being trans wouldn't fit here, but gender reassignment of children might be. Alternatively something could be considered abnormal or pathological if it leads to either unhappiness or to lack of function. This is where the dysphoria notions can be discussed. The debate of course is whether the dysphoria is connected to being trans or to the reactions of others and society to one's being trans. The later then would be a political issue again. The former to psychological illness. And, finally mental illness can be discussed in terms of some proposed ideal state of humanity or some ideas about reality testing and truth conditions. Again, there is plenty of room for debate on these issues. Given these considerations the issue of whether trans is mental illness, or causes mental illness, or has certain vulnerabilities for mental illness seems to remain undecided.
20
There are well-documented psychiatric disorders which occur in a constellation with gender dysphoria. I do not say this to shame anyone, because you cannot change the health you inherit.
There is also a particular type of male violent offender who has a paraphilia for dressing in women’s clothing. This activity is one of well-known behavior patterns reflected in academic literature and used by behavioral profilers.
This is not to insinuate that all trans men will, or want to, commit crime. But the link is clear and well-established for a subset of men who do, along with several other classic cardinal signs.
Completely eliminating gender dysphoria as a psychological classification within that field of study is wrong.
54
@John Smith Subsets of nontrans men commit heinous crimes. That doesn’t mean that the larger category of nontrans men should be seen as disordered. The profilers should get back to work. It is also well documented in the academic literature that women who refuse to do housework and wear dresses are disordered. Please cite the literature you refer to.
5
@Elaine What do you mean by "disordered"? If the mental "circuitry" of the brain doesn't match the body's circuitry, then that suggests a disorder of some kind, no? The issue here is science, not politics.
Similar to gender dysphoria about 1-3% of the population is affected by Body Dysmorphic Disorder. That doesn't mean people should be stigmatized, and definitely not discriminated against, it just means that their brain's circuitry feels like there's a mismatch between it and the body's circuitry.
Let's keep the discussion about science and not about politics.
8
@Elaine Yet the vast majority of violence (98%, some say) against women is perpetrated by men. This is the number we need to acknowledge—not how many men offend but how many offenders are men. And there are also reliable reports that male-pattern violence rates remain unchanged when a biological man identifies as and lives as a woman. (Check out Karen White. And the issues with paraphilia being conflated with “real” transgender status — whatever that is — in the UK.) Somehow self-satisfied progressives (of which I am one) don’t seem to want to acknowledge this and are stroking our own egos for being inclusive as exclude women—again. It’s easy to say “not all men,” but it harms women to put men’s feelings ahead of women’s safety.
32
"gender dysphoria" is a gift to help one understand that the body DOES NOT MATTER. Investing so much energy in changing your body is the path away from wisdom.
Mutilating yourself and putting yourself on deadly hormones is extreme self harm.
The doctors who are doing this are violating the basic precept of do no harm. They are criminals.
32
@Audaz. It’s not up to the doctor. It’s up to the patient. Cases of genital reasignment at birth is unacceptable for intersex infants. That’s a different matter. A transgender person will decide what they want. Not you. Not the doctor.
1
@Audaz
'"gender dysphoria" is a gift to help one understand that the body DOES NOT MATTER"
What ???
Have you personally experienced it - or are you just surmising - and then declaring your assumptions as some sort of dogmatic (and I might add condescending) "truth"?
1
@Audaz Aren't those the same hormones that half the population has naturally? Must not be too deadly.
3
"In Indonesia, on the island of Sulawesi, there are three sexes and five genders". But there aren't 3 sexes, unless by some logic you are telling everyone that these people aren't in fact human, which would be a little troubling. Humans have 2 distinct sexes like all other mammals, 1 produces large gametes (eggs) and the other produces small mobile ones (sperm). The latter claim about 5 genders can be debated if you're a subscriber to social constructionism. But I'm not giving the former statement any credibility.
Moreover, the claim that "[b]etween 1 percent and 2 percent of all human births qualify as intersex" is false.
Leonard Sterling in "How common is lntersex? A response to Anne Fausto‐Sterling" published in the Journal of Sex Research did a thorough job in disproving that claim.
The number of people who are not readily identifiable as male or female are approximately 0.02% of the population or 1 in 5,000. For some perspective, the chance you will be struck by lightning in your lifetime is 1 in 3,000 according to National Geographic.
68
@Mark F
If
World population = around 7.5 billion
Percent not readily identifiable as male or female = 0.02%
Then
around 1.5 million people not easily identifiable as male or female.
1
@Mark F
If
World population = around 7.5 billion
Percent not readily identifiable as male or female = 0.02%
Then
around 150 million people not easily identifiable as male or female. Not a small number by any accounts.
1
@Mark F — It depends what you mean by intersex. Fausto‐Sterling means nondimporphic sexual development, not ambiguous sexual development. The claim ”There are only two sexes” seems to address the first criterion more than the second.
Also, imagine a long-lived society with roughly equal numbers of XX, XY, and 45,X individuals. (The last group has a distinctive physique at all ages, has some sexual anatomy in common with the other two groups but no sexual puberty, and is infertile.) That society would say there are three sexes and I think they would be right.
2
We should not normalize or fetishize the immense suffering caused by acute gender dysphoria. Words still have meaning.
17
@Chi Lau. So many armchair experts here with one-liner dismissals. By definition, what the DSM calls gender dysphoria is NOT "acute"; it's chronic.
2
Being human generally involves a certain amount of psychic or existential pain. Musicians and writers have known this forever. Somehow now we are supposed to feel comfortable and happy all the time. And find a remedy if we aren’t.
Since precious children are involved it might help if the message were not—“You feel pain in your life. Maybe you have been identified as the wrong gender.” But rather the message- “Deep psychic pain is a normal part of being human. Here are some things- work, creative endeavors, faith, prayer, nature, exercise, and so on- that people have found helpful. You are a loved part of a community and we will be there for you through the pain.”
Adults can be transgender if they want— it’s their life. But this remedy shouldn’t be encouraged for the children still figuring things out.
110
@JK
There is a lot of care around transgender children, the hormones and the surgeries and the like only are started once the kid and those working with him/her are sure have demonstrated that they are old enough to make that choice. The only treatment in general they use on transgender children are hormone blockers,especially with children born make identifying as female, because if in fact they are transgender, if they when they are old enough to make the final decision(s), stopping puberty like that is huge, once male hormones take effect it causes changes that make it a lot harder to transition, as any transgender woman who transitioned as an adult will likely tell you (voice, size of hands, bone structure, beard, brow bossa, number of things that it is very hard to fix later).
Sorry, but 'deep psychic pain' is not part of being humans normally, we are not talking grieving or heartbreak of broken relationships here, and this idea that 'deep psychic pain' should be experienced is ancient Catholic BS; there is a difference between feeling pain, emotional or physical, grieving, injury, and what a transgender person feels. The kind of pain a transgender person feels is more and telling them to experience it is like telling a cancer patient not to have pain relief medicine, this isn't dulling the pain of a muscle ache.
4
@JK
The diagnosis of mental disorders requires that the symptoms of them cause significant distress and significantly interfere with the ability to function.
According to you, this applies to everyone which raises the question of if no one is able to function, how come the world doesn't collapse?
2
@bill d Brava!! The pope told his trans guest to "live in the body he was given". Hmmmm, does that mean don't repair spina bifida, as one is born in that body? Or heart defects? Or six digits? That's like saying any baby born with a birth anomaly ought live in the body "God" gave them. Pssshh, biology is very capricious and imperfect. Thank you
2
I'm disturbed by the sheer number of people on here claiming the "WHAT ABOUT THE KIDS????" argument. Same thing happened with gay marriage, and turns out the kids are fine. The author doesn't talk at all about kids, giving kids hormone treatments, or kids receiving reassignment surgery. A bit of disingenuousness on the part of these commenters.
8
@Tim Fredrick The issue with "transgender" is adolescents. Adults are free to do what they wish. Guys in dresses with makeup on their 5 o'clock shadow - not a problem. But giving adolescents puberty blockers is malpractice.
16
@GeorgePTyrebyter. Um, George? Give a trans teen blockers, and she won't ever develop a hated beard to hide. Or he won't ever grow hated breasts to hide.
Get it now?
I don't think we should discriminate against anyone based on their sexuality or gender, but this article confuses me a bit.
I thought one of the arguments against homosexuality (and I'm assuming transgender) was that it was a "choice". I remember when I was growing up a long time ago that there were a lot of "being gay is not a choice," type of arguments. But the author of this article says, "Our sexual lives and identities are determined not by our genes but by our cultures." That seems to indicate all choice and no chance to me. I don't think the science is that clear cut. I think the author is too extreme in dismissing the role of biology in sex and gender. Making a case for multiple genders and sexual behavior based on 1 to 2 percent of births qualifying as intersex seems like bad science.
A man can choose to live as a woman and I think that's all right and I don't care if it's cultural or biological or magical. But many other people don't think it's all right and I'm not sure how the arguments in this opinion piece will change their minds.
20
@Steve S
I think you are confusing what the author is saying (who c learly says that people are born transgender or gender non normative). If you read the text that precedes "our sexual lives and identities are not determined by a our genese, but our cultures" they are talking about the acceptance of gender identities and roles in other societies where behavior that the conservatives in this country would consider "mentally Ill", "abnormal", "unnatural", they don't judge it and because of that, people are free to be themselves.
Using homosexuality as an analogy, how many gay men in the 'good old days' ended up with lives where they got married to women, had families, and were miserable but they knew they couldn't live openly as a gay man, and often had to 'pretend' to be straight because a single man would be looked at askance?
With kids who are gender non normative, as the article notes there is a tremendous pressure in society, even today, to conform to norms, and despite the changes in recent years, kids know that if they start acting as they feel, it will be dangerous to say the least. like with gay kids, a lot of trans kids end up running away from homes and communities where they are bullied and worse, parents still throw kids out who 'don't act like a boy or girl'. Talk to people who come out later as transgender, and you hear stories where the fear of reactions made them hide, bury it deep, because they knew how harsh society was (and still is)....
3
@Steve S The author is stating that surrounding society dictates what gender you are, even if your genes and/or developmental wiring tell you otherwise. Society is not giving people a choice to listen to themselves. That is problematic.
1
Gender, like race, is a social construct. Nobody is "born" with innate social constructs. Sex is biological, and speaking objectively, yes, binary. except for the anomalies, (even if the word anomalies hurts some feelings, that is what exceptions, outliers are) which do not define the norm. Transgenderism might his the rejection of the social construct and the stereotypes, agreements, roles, expected behaviors such social constructs impose on us based on our sex, assuming the ones assigned to the opposite sex which I agree might not be a mental illness. The question: is there a difference between the rejection of the components of the social construct only and that plus the rejection of your biology? Is the first one Transgenderism and the second one Transexuality? Is the first one normal and the second one not? or are they the same as sex is such an intrinsic component to the definition of gender?
5
By what basis do we consider anorexia nervosa or body dysmorphia as "disorders" if we accept the author's premise?
Sex is dimorphic - we do not "assign" it, we instead recognize it, and it is strongly correlated with gender.
Intersex conditions are rightfully treated as disorders of the reproductive systems, deserving of sympathetic and informed health care. Something has gone wrong in the womb or in the chromosomes, often resulting in sterility or abnormal hormonal / phenotypical expression.
Transgenderism is the canary in the coal mine for a progressive left that has abandoned science and rationality in favor of identity politics and feelings.
99
@James You need look no further than today's GOP to see how politicizing science is bad practice. Democrats and the Left should not emulate this practice.
Transgender people are human beings same as everyone else and should not be stigmatized. Moreover they deserve the same anti-discrimination protections that minorities and women benefit from.
But none of those political values mean we should politicize the science. Science is science, politics are politics, and the two should not be confused.
9
@James. Body dysmorphism is commonly conflated with transgender by those who proceed dogmatically from biological sexual dimorphism and disregard that gender is socially constructed. The article references several cultures with more expansive concepts and categories of gender than ours, irrespective of physical sex.
Transphobia is the canary in the coal mine for a reactionary right that defies evolving science and irrationally clings to outdated prejudice...
3
@James Disorder implies harmful. Being trans is not inherently harmful, therefore, not a disorder. Do you think that the professional organizations that study these things make things up?
2
Family doc here, see trans folks from time to time.
Let's change diagnosis to "transgender" and move on to the next case.
Easy done.
20
@vbering
love this!
1
I am a transgender man and a clinical mental health counselor. I appreciate the writer’s points about destigmatizing our community. We are regular people, we are members of families and communities, and we deserve to be treated as such.
I’m not sure that Gender Dysphoria should be removed from the DSM. The text states explicitly that gender nonconformity is not itself a mental illness; the persistent distress caused by the mismatch between body and mind is. Being trans is profoundly different from being gay or lesbian. I experienced gender dysphoria as an all-pervasive misery that nearly ended my life. It wasn’t just my social environment but the condition itself. Hormones and surgery were life-saving medical interventions. (To the commenters concerned about children: media hysteria aside, actual treatment protocols for youth are sound and involve zero medical intervention until adolescence, by which time gender and sexual identity is much more stable. Irreversible treatments are not provided til patients are 16 or older.)
What does it say about how we view people who live with depression or bipolar disorder or who are on the autism spectrum if we refuse to be described in the same text that they are? All these terms describe regular people who deserve dignity, acceptance and treatment. All are part of the natural (if often painful) variation in our species. I am not ashamed to be in their company. Let’s destigmatize mental illness, period.
41
@Shalom
I see your argument, and also see you are also wanting to be cautious. But you say "Irreversible treatments are not provided til patients are 16 or older."
But even reversible treatments are still treatments, and condition the choices and sense of control the young individual then has. If a parent, for example, encourages their child to explore a non-binary sexual identity, for example, and then also employs a therapist to further encourage, is that really still allowing freedom to the child?
I do not think your parenthetical comment does much to comfort those of us who are concerned -- and we might be wrong! -- that children are being put into conversations they are not equipped to handle, and even the most caring adult interaction is thus a coercion, and inappropriate.
I hate to have to say this, but I will. There are reasons for the age of consent. No matter how gentle, no matter how caring, no child can genuinely consent to sexual activity initiated or prompted or encouraged by an adult.
I see no reason why this proscription should not also apply here. At the very least, it suggests a much stronger caution than you seem to think is needed.
26
@Shalom. Aw, don't confuse them with hard facts and authentically lived experience. Can't you see that they love and crave their stubborn prejudices? /s
Seriously, thanks for the best comment I've seen here today!
3
@Shalom
I don't think gender dysphoria should be consider a mental illness. Research suggests it is cause by abnormal prenatal development of the area of the brain that governs perception.
I am confused by the term, "assigned at birth." Except in rare cases, are we not born with either an xx or an xy? Nobody "assigned" us that, except which sperm hit the egg. If we are going to make decisions about this, can we not begin with facts? Or is this not a fact? I'm open to reasons why it might not be.
87
You will never get a response. There’s just too much money involved.
20
@Kathleen880
You are correct. No one "assigns" babies a sex at birth. Doctors identify the sex of babies at birth. In a small precent of case, they resort to chromosome testing.
40
@Kathleen880. Assignment in this context is the sex marker that goes on the birth certificate, based on nothing more than observing the newborn's external genitalia.
Sex and gender are not the same thing.
3
It's a mental illness when you have the body of a man and an XY chromosome but you claim to be a woman; or vice versa. If it's not a mental illness then it's a scam or a collective insanity in a PC world. Either way, it's going against the FACTS.
67
I would divide this article roughly into two parts
The first was thoughtful in considering the path trans people have walked to have their right defended by law, through the excision of "homosexuality" from the DSM, the registry of mental disorders. Thinking about people being forced against their will to follow "corrective cure" is, in a simple word, inhuman. Everyone has the right to be oneself.
The second part, alas, get the social warrior out of the author. There is no such thing as gender fluidity, repeating ad nauseam that 1-2% of people are born with mixed genitalia doesn't make a majority of cases (not to mention they are combination of 2 only genders' one). There are people born with 6 fingers, there are siamese twins, and nobody has ever tried to force a change on the number of limbs for a generic human being.
The worst comes out when the author tries unsuccessfully to turn the table charging all-but-trans with the "gender disphoria" they are feeling, as symptoms and cause of the stigma trans people are living. Apart that stands as the total reverse from the kindness to other the author wanted in the first part, it's clearly an absurdity trying to impose that 1-2% of world population cases is the reality against the 98-99%.
There is a saying, on scientific matters, that a law is what happens all the time, and the exception confirms the law, (because it's that, an exception).
36
I only have a couple of thoughts on this, and no specific expertise, but as an epidemiologist and a mental health practitioner I'd only comment that, 1. Physically being intersex (what we used to call hermaphrodite) is a different thing than being transsexual (feeling that one is a different gender than the biological one); 2. It must be extraordinarily difficult to estimate the true prevalence of something like transsexualism-- and why does it even matter? 3. The DSM was really intended as a dictionary, not a bible; 4. Definitions of "mental illness" should depend on the individual him/herself feeling that they have a problem (not just an identity, etc.), and the DSM definitions generally do include that criterion. But it can be a slippery business... what if the distress is due to the person being stigmatized or persecuted? What if being stigmatized or persecuted leads to personality traits that are not so attractive? None of this is very simple. I suspect it all will be debated for a long time.
18
@Phil Somervell Your point that this will be debated a long time has rung true to me for a long time. We know next to nothing about how the brain works and until we do we can't really say scientifically why the brain's circuitry may not match the body's plumbing.
So until we understand the science we should keep the focus on protecting and welcoming transgender people.
An interesting question will arise once we understand the science and some biochemist devises a pill which ensures the brain's circuitry matches the body's plumbing. If a pill can eliminate the mental anxiety/distress associated with the condition, then all that hormone therapy and surgery can be eliminated--no doubt some non-trivial percent of the population would vehemently object to that.
2
Here's where reality meets idealism. Keeping "gender dysphoria" on the books as a disorder instead of classing it under a different medical code changes the way insurance views it and consequently covers it. The former has to be at least partially covered under one's insurance while the other gets lumped into "elective" and typically becomes exempt from any insurance claims. The cost of hormonal treatment is often prohibitively expensive for the average person. Gender reassignment surgery (total or partial) is typically not covered by insurance and consequently a large number of transgendered individuals opt not to have the surgery. It may not be the socially ideal solution, but until we have nationalized healthcare these types of schemes will persist when doctors try to provide better care for their patients' needs despite insurance company's attempts to deny treatments.
10
Whether born male or female there are many shades to how much one "feels" like they are male or female, regardless of what your genitals look like.
I don't agree that medical interventions like surgery and hormones - that alone can have profound, permanent affects on your body and how you feel - should be promoted as a solution. Many people dislike their body for various reasons, and our culture pushes everyone to "fix" their bodies if they don't like them. I'd rather find peace with the body I was born with, which continues to change throughout life anyway.
I always thought we would progress so that people could be themselves anywhere between the stereotype of what is male and female. Who decided what it "feels" like to be male or female?
I wish there would be more open discussion in general about our evolving notion of gender. The discussion seems too narrow with foregone conclusions.
48
@Rebecca. On one hand I agree with you. It would be wonderful if we had progressed so that as individuals we could be as masculine or feminine as we'd like and be comfortable with our own bodies. If we could move beyond labels and stereotypes and just be our own true selves.
But on the other hand, our bodies often introduce us and shape social interaction before we even have the chance to express who we are. And I think you might be underestimating how difficult it is to find peace with your body when there is mismatch between your gender identity and your physical sex. One can behave how they'd like, dress how they'd like, modify the body through diet and exercise, but it won't fix the persistent sense of wrongness, of being forced into an ill-fitting and itchy suit that can't be removed, of having body parts that feel alien.
1
@Rebecca Exactly. Many years ago I worked in an internal medical practice which prescribed hormones to transgender patients. I always wondered what the heck they meant when they'd tell me "I feel like a woman in a man's body." I am female. I have no clue as to what makes one "feel" like a woman. I "feel" like me. Not like a woman. Not like a man.
I knew nothing about mental disorders at that point in my life, but these patients seemed truly bizarre. The males wishing to be female were especially strange; the females wanting to be males seemed more "normal" to me in their social behavior.
My assessment is that "gender dysphoria" is definitely a mental disorder. Human beings who want to mutilate themselves and take dangerous, harmful medications because of the uncomfortable feelings they experience about physical anatomy are out of contact with reality.
21
@A. Hominid No, they are not. Please research this subject from years 2016-17, in articles in web sites ending with .org, or .edu. It is a complex birth "defect" in the class of inter-sex. The brain contains a gender ID area, along with areas monitering body awareness and movement. A person is born the gender they are, with the wrong genitals. Have you researched before commenting they are out of contact with reality? To me, humans always need a scapegoat to hate, esp religious. You can look back at history, and it happens over and over and over. You cannot base opinion on what you experienced many years ago. Fantasists who believe opinion is fact are out of context of reality.
So Gender Dysphoria appears not to be a diagnosis of an individual, but of our culture, which can't seem to refrain from persecuting those who don't conform to it's arbitrary "gender norms."
8
I went to MBA school with a man who is now sometimes listed as the "highest paid female CEO." A victim of society he was not. He (now she) was perhaps the most arrogant man among all the MBA students. You don't know what "mansplaining" can be until you've heard him (now her) mansplain to you. Most of our fellow students despised him for his toxic masculinity, the way he held their powers of rational thought in open contempt.
But I tried to put up with his bad manners because I could tell he was right: he did have the most brilliant mind for sheer masculine logic of any of our colleagues. He went on two earn two fortunes, including a second one for inventing a new medical treatment for the disease suffered by one of the several children he (now she) had fathered.
My impression is that a surprising number of late onset M2F trans individuals are this kind of Ayn Rand hero: high IQ, low empathy, low regard for the feelings of people around him/her.
Oddly, the conversation in the media never seems to pick up on this pattern common among the most famous late onset M2Fs. We are stuck in a politicized rut where we can't see the reality in front of our faces.
52
@Steve Sailer
Um. No.
Just no.
Most trans people I know are very kind, very empathetic.
2
@Steve Sailer. Did it ever cross your mind that this toxic masculinity was an over-compensation? It's a very common behavior among trans people in denial, and, once established in a driven personality (and reinforced by high career achievement) not something that changes effortlessly once the underlying gender issues are addressed. And, BTW, it's not "late onset"; it's late accepted.
1
@DMC
If it were easy to "over-compensate" your way to a huge fortune the way my old MBA school colleague did via his/her obsession with rocket ships, lots more people would do it.
In 1981, he (now America's high paid female CEO), told me he was going to get rich off of Outer Space. I replied to the effect that I was a science fiction fan too, but wasn't Outer Space kind of a money sink for the government?
But today I send the company he co-founded a monthly sum for their Outer Space-based service.
Now, I'm sure you are saying: "Oh, he/she just pretended to like rocket ships to cover up that he/she really loved dolls on the inside."
Perhaps. But Occam's Razor suggests that the reason he got rich off Outer Space is he really, really did love rocket ships and other boyish things.
This pattern seems common among other late onset M2Fs like Professors McCloskey and Conway: high aggression, high IQ, and low empathy.
These individuals aren't exactly Fictims of Society.
9
Not a disorder but intimately connected with the mind and making choices based on personal experience.
1
I want to treat all people respectfully but how can it be that at least some people who want to surgically change their sex are not emotionally disturbed and may eventually elect to remain male or female? And if say a 9 year claims to want a sex change isn't that too young to be of sound mind on the matter? Is the label then only for kids?
10
I'm transgender and I think that since we are a natural genetic derivative just like gay people, we shouldn't be considered mentally diseased.
Gays used to be considered mentally ill, and now they are considered a normal genetic condition. Transgender people aren't some disease created by western society or social construct. We have existed since the beginning of humanity, and we are a normal expression of humanity.
To be considered mentally ill is a social construct. As a social construct, it can be changed just like what happened with gays. We as a society need to view transgender people as a natural thing that doesnt hurt anyone.
Even if you view being transgender as a disease, you cant also accept that the treatment is to live as a transgender woman. If it's not a disease then living as a transgender woman is a natural thing. Either way the result is the same, we just need acceptance.
16
@Jacqueline Exactly!
1
The author states, "It would be an important step in advancing transgender rights and reducing the stigma and prejudice that people experience when, because of nothing they or anyone else did wrong, they cannot abide the sex they were assigned at birth."
I think this is a misreading of the DSM-V's classification of "gender dysphoria." The APA is not "blaming the victim." Gender dysphoria is defined as the emotional distress that can result from “a marked incongruence between one’s experienced/expressed gender and assigned gender.” The blame for the "dis-ease" is on society and the cruelty heaped upon the trans community by a society that is completely ignorant of their needs and struggles.
However, I do agree with the author. We have a long way to go...
7
Yes. The paragraph cited above was one of the oddest paragraphs I have read in a long time. I’ve read it over and over again thinking “What?” Is the author assuming that blame is always assigned? Surely we can assume more understanding of mental illness than that paragraph implies.
2
I am not convinced that being transgender is not a mental disorder, but whether it is a mental disorder or not has nothing to do with whether trans people should be able to live safely as whatever gender they wish, or believe, themselves to be. The violence against trans people is appalling, and trans people should not be coerced into treatment against their will. Period.
Where it becomes more complicated, to me, is in reconciling the right of trans people to live freely with the rights of others. Trans people rightly demand recognition of their right to live freely and safely and that right must be protected. But they can't change the fact that they are not physically the other gender, and that means some distinctions will remain and those will affect or concern other people. For example, bathrooms: there is no question that trans people must be able to go to the bathroom safely, exactly like any other person. However, the discomfort that some feel with sharing a bathroom with someone physically of the opposite gender is not 100% unreasonable - even though history shows that trans people have not been a sources of violence (but have tragically nearly always been victims). Why is it not acceptable to simply have a safe bathroom for anyone whose gender doesn't fit the male or female box?
11
@E - For decades, trans people have been using the bathroom of the gender they dress, look, and act like, and no one has known the difference. Once someone has transitioned, to demand that that person goes into the restroom of the gender they were born as is a disaster waiting to happen. If a transman (bornn female) goes into a women's restroom, it's going to be upsetting to everyone, and if that becomes law, then women will no longer be able to tell whether that very masculine-looking guy in their restroom is trans or is a cisgender male pervert taking advantage of the laws to prey on vulnerable women.
2
This is a VERY important article and some incredibly good points are made here:
1."Being trans should be a personal or social identity, not a psychiatric one."
2“ 'Gender dysphoria' also puts the responsibility on trans people for their suffering, and not on the social and moral environment that stigmatizes them."
It took me a long time to genuinely understand that gender is a social construct. For me, becoming the mother of boy/girl twins was one of those events--for I can tell you that those babies came into the world reacting pretty much the same way. Did they have differences in behavior? Of course, but only over time did I realize how we tended to reinforce their behavior when it most adhered to the gender norm. So many years later, my son is the artistic nurturing one and his sister the more pragmatic partner. Yet she is the one that loves girly clothes; he is not interested in frills. They are--egads--fully formed, 3-d individuals.
The one thing that has struck me is the high suicide rates amongst transgender youth at a time when gay/lesbian suicide is in the decline. "
I am of the mind now that gender fluidity may save us all--the angry white men who are conditioned to not feel their feelings and women who are relegate to the side. Let's jointly throw off the shackles of gender so that we may have a more harmonious and creative existence.
12
@GWE Gender is in "many ways" a social construct--girls wear pink, boys blue, etc. That only became true when large retailers decided they could sell more clothes that way (Smithsonian has a great article about this using early childhood pictures of FDR--he looked and dressed like a little girl--as an example).
But gender isn't entirely a social construct. Men have genitalia which distinguishes them from women. More importantly if the brain's "circuitry" believes there's a mismatch between it and the body's "plumbing" then there is an issue with that individual for which medical intervention--hormone therapy, counseling, etc--may be necessary.
This over simplification that "gender is just a social construct" is not scientifically productive. Its mere political posturing.
1
No, it’s not a mental disorder. But, it is a physical disorder, that is, in fact, treated with hormones and surgery. There should be nothing shameful or demeaning about that.
3
Yes!
I have a young trans person in my life who has had to jump through an extraordinary number of hoops just to get a gender dysphoria diagnosis. This young person has no mental health issues, is happy, has normal relationships, is a strong student, and has been very consistent about his male identity. The gender dysphoria diagnosis was necessary to begin physical transitioning.
The medical/mental health establishment has been excessive in its gate-keeping role, and the key to change is to remove the "diagnosis" element.
Thanks for this editorial.
5
I think the social stigma portion of this is a little weak- depression is a mental illness- do we go out of our way to mistreat the depressed individuals in our lives? While of course I understand the issue of stigma against mental health issues, promoting civility and understanding of individuals with these issues is the answer, not covering our eyes and saying there's no problem there.
If gender dysphoria warrants medical procedures and medication, then I'm sorry- it's a mental disorder. Gender really isn't something we pick and choose like clothing. That doesn't mean everyone will go out of their way to harm trans people- common courtesy and civility are warranted towards everyone. But saying it's not a mental health problem is injecting politics into science, which is wrong, and a reason many individuals in healthcare don't agree with declassification. It's not an identity choice question when you're cutting or injecting drugs into a person- that's a bonafide health problem
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Sometimes I feel tired and not like doing anything and think maybe I'm depressed. Now my eyes are open to a whole new avenue self-exploration.
1
But what of the fact that, in the past, most kids w gender dysphoria eventually remitted, and became comfortable w their natal sex?
That indicates that many gender -dysphoric kids are experiencing something other than being trans...
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@Megan
The most credible estimate I've seen is that 2-3% of kids who initially think they are dysphoric change their minds. That is incredibly low.
The much bigger risk to to not believe or affirm a dysphoric person, no matter how young.
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@Megan. That is simply not a fact. Stifling for the duration of an unhappy life, substance abuse, and other coping mechanisms are not at all the same as "becoming comfortable".
Something that is innate most likely hard-wired into the brain (as the most promising science suggests) does not "remit".
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@Megan
The data is that over 80% of children who express unhappiness with their sex grow out of it and become normally happy with who they are.
Lots of girls are tomboys, understanding that males have more freedom and are more valued. The transgender ideologues would have all these girls surgically altered, when time and puberty results in tomboys coming to acceptance of and happiness with being female.
Swedish research found that transsexualism was rare, 1 in 30,000 males, 1 in 150,000 females. But now that the transgender ideologues have seized the imagination of the science-illiterate public and the ideology has been spread by social media, huge numbers of children and teens are now claiming to be transgender. And the medical profession responds by putting children on puberty-blocking hormones that will render them permanently sterile.
Jazz Jennings, a boy claiming to be a girl who has become a media darling, was put on puberty blockers. The drugs left his genitalia so shriveled that there is not enough tissue to make a fake vagina for him. And he will be permanently sterile.
Maybe after enough children who have been surgically and hormonally mutilated sue doctors for "transitioning" and sterilizing them, this transgender nonsense will abate.
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Yet again somehow clearing the editors is the mistaken (overt mistruth) assertion that intersex births comprise 1%-2% (occasionally 3%+) of all births.
A make-believe sociological study that classified all manner of birth effects as 'intersex' led to this outrageous number.
Most sensible actual Dr's and research place this number at about .05 - .1%.
You don't get to make up data to increase the prevalence of what can 'sometimes' be a medical/mental disorder
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If being transgender is not a mental disorder, why should anyone receive insurance benefits for hormone therapy or gender reassignment surgery. The author argues that it should be treated like a "physical health concern", but it clearly isn't a physical health concern. If it's not a mental disorder and it's not a physical disorder, it's not a health concern.
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Did you read the article? The author wants the codes associated with transgender health to be removed from the psychiatric chapters of ICD to the sexual health chapters. Clinicians will still have codes for reimbursement and insurance coverage, just in a different chapter.
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@ms -- I did read the article. What the author wants is to have it treated as a physical health issue. The problem with that is, it isn't a physical health issue, or at least, it hasn't been shown to be a physical health issue.
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Not so fast.
Significant numbers of children are presenting with gender dysphoria and once they go down the medical pathway to transition - puberty blockers, followed by cross-sex hormones and possibly surgery - they are medical patients for life. The drugs have serious consequences, such as bone loss, sterility and sexual dysfunction.
Given there are children involved, and that a high proportion of them may be on the autism spectrum, psychological evaluation and extreme caution is absolutely warranted.
Further, it's extremely disappointing to see intersex people used as a political football in this discussion - nobody has shown that trans people have higher rates than intersex conditions than any other population. It is disingenuous to co-opt them for this discussion.
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@Fenella
The number of teens reporting that they are trans seems to have increased dramatically.
I recently attended a presentation for MDs by the clinicians in a department providing gender reassignment treatment at a local children's hospital. I asked a question: "how often does the evaluation result in a decision that the person should not receive medical treatment to further the transition?".
The answer was that they don't turn anybody down, but occasionally delay the onset of the treatment.
Since I have seen post-surgery adults change their minds about being transgender, this struck me as concerning, to say the least.
That clinic requires a psychological evaluation, but imposes no training requirements on the psychologists who can provide it.
I'm not arguing about the APA position. I'm just pointing out that this is not the same issue as accepting homosexuality. The medications and surgery make it different.
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@RickP Yes, 4000 % (yes, percent) increase in UK is being studied. In US, Lisa Littman has begun research on the phenomenon, and when lay people and activists (including the dominatrix “Hailey Heartless”) reported that her research offended them, her institution (Brown) threw her (and science) under the bus, disavowing the researcher they previously found impressive enough to hire and support. It’s ironic that this treatment is congruent with the treatment of women in academia, which happens not because they “identify” as a particular “gender,” but because they are members of an oppressed sex class.
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I actually don't care about whether adults are confused about their identity. Guys in dresses? Sure, I don't care. The problem is kids. 1) Guys playing on girls' sports teams is wrong, unfair, and a violation of Title IX. 2) Giving adolescents puberty blockers is malpractice 3) Giving "transgender" kids MORE rights by allowing them to change in the locker rooms not consistent with their anatomy and chromosomes is a violation of the privacy rights of 99.8% of non-confused kids.
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@GeorgePTyrebyter
Remind me, which of our chromosomes is the "locker room" one again? Is it near the "train station magazine section" one? Or is it closer to the "side of the shirt that the buttons are on" one? Gosh genetics are confusing.
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@GeorgePTyrebyter
I don't know any trans kid who is confused. I wonder how much time you're spending with young people these days? The kids truly don't care about gender. They are leading us all.
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@Cousy
They are not leading me.
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