Are Transsexuals Mentally Ill?

[Martin Hyde]

Originally Posted by Una Persson

That fact that you believe homosexuality is a mental illness (quoted above), despite what the current DSM-IV says, means that you are in opposition to established practice in the psychological field, doesn't it?

As I said already, the DSM-IV doesn't define mental illness, mental illness is not defined by the DSM-IV. I believe homosexuality is a mental aberration consistent with most pop cultural definitions of mental illness. The DSM is about giving physicians the ability to diagnose something, almost overwhelmingly for billing purposes and reimbursement purposes. Since homosexuality does not have any accepted medical treatment and most have come to not view it as a problem it makes sense it wouldn't be in the DSM.

Obviously the only reason for the DSM isn't financial, it's a diagnostic manual, but a psychiatrist really only uses the DSM codes to get justification for the treatment and drugs he's going to prescribe. A practicing psychiatrist for example knows that a person with "schizophrenia" is going to fall within an extremely wide spectrum and the DSM is really just a rough way of saying "he's roughly under this category, and people under this category are customarily treated in this way." The DSM doesn't actually define the condition, the condition existed before the DSM was ever created.

Why does it have to be so similar? You seem to be placing male and female brains into binary physical states, which I not believe is true even if transsexuals never existed. There isn't a template for a brain which you can hold up to an MRI or dissection and say "male" or "female."

I'd agree with that, actually. I'd be shocked if there was a template for "male" and "female" brains, but I'm not the one who wants to say a variation in trans men's BSTc means "they are men with female brains." Do you think there might be a reason none of the researchers who have looked into the BSTc abnormality in M2F transexuals has ever stated "the subjects appear to have been men with female brains?"

And the DSM has been wrong in the past, changing the classification of homosexuality. Relying on the DSM for this argument is starting on a shaky foundation.

The DSM-IV doesn't define what is an illness and what isn't, it just establishes diagnostic codes that psychiatrists are permitted to use when it comes to following accepted treatment techniques and getting the treatment paid for (the overwhelming majority of people treated for conditions described in the DSM receive most or all of their treatment through State or Federal funds.)

Homosexuality falling off the DSM isn't necessarily proof that it isn't a mental disorder, but only proof that it is not treated by accepted medical practices as it isn't seen as a problem.

Now, I think homosexuality is a problem as many homosexuals have a variety of problems. Namely they clearly have sexual dysfunction and delude themselves that various acts with people of the same sex is a form of sexual intercourse when we've evolved to reproduce by having sexual intercourse with the opposite gender. Homosexuals also often have various emotional and mood problems along with depression. I think we should be looking into treatments and cures for homosexuality or at the very least let's understand what combination of genetic or developmental conditions leads to the affliction so we can eventually eliminate it in future generations.

However for political reasons it became unacceptable to try and treat homosexuality, and part of that of course is because the treatments people were using back when it was in the DSM-III were crude, ineffective, and based on grave prejudice. That isn't a reason medical researchers (away from a clinical setting) shouldn't be looking for solutions that could make their way back into medical practice.

I already did the legwork and forked out the cash and conducted more than 40 hours of research on this subject. Perhaps you should read the subset I posted above before we go any further.

I have no problem with paying money to get access to research works, I do it all the time and have expensive subscriptions to several databases of such works as well. However you refuted my specific statement that "I was glad to see Cecil acknowledge GID as a mental illness" by saying "I think he was too pessimistic and my eighteen research articles show this." But upon actually reading the post in which you linked those articles, and the titles of those articles, it appears those articles have nothing to do with whether or not GID is a mental illness. Instead they suggest efficacy rates of treatment options for GID patients.

It's simply not a honest position to tell me "well, what I'm asserting might be in one of those articles which are superficially about treatment but not about the definition of GID as a psychiatric disorder, but I'm not going to indicate which ones might hit on that and instead insist you fork over money and read all eighteen articles." I'm sorry but no, you presented those arguments to support a claim before I ever posted in this thread: that Cecil was pessimistic about success rates of treatment for GID. If you now want to say those articles also support another claim, that GID isn't a psychiatric disorder then you need to actually give some justification for that and specify exactly which articles support that assertion.

Now further, I have actually not specifically said we should never perform SRS. I have said nothing on that topic in this thread, in the past I've had different opinions on it but basically ultimately have concluded if nothing else works then it should be used. However I don't view it as a "solution" anymore than I view a wheel chair as a solution. A wheel chair provides mobility, absolutely, but I still want people looking into a solution for various afflictions that put people in wheel chairs so that some day they can be fully ambulatory without wheel chairs.

What I would actually like to understand is why people do not think it is a psychiatric disorder, what do you think GID is if it is not a psychiatric disorder? Do you think a normally functioning human brain will tend to believe, and truly feel that something about their body is "wrong" and that they are "really" something else? Do you really believe it is more likely that the body is somehow "wrong" (even though its function is perfectly normal) and the brain is right?

For virtually every other scenario like that, except when talking about people who believe they are a different biological sex, there is no controversy: the brain is wrong and objective reality is right. Only when people are believing things in contravention to reality about their sex do we say objective reality is wrong and the mind is right.

Biological sex is not based on feelings or thoughts, it is based on your genetics and your physical attributes. The whole concept of biological sex exists to describe all the physical differences in species with multiple sexes. These differences are almost entirely all physical and relate to physical capabilities and aptitudes.

Humanity is the only species we know of with cognition and rational thought on par to even have issues like this come up, but in human society we have "gender" which isn't quite the same as biological sex. "Gender" is essentially the acceptable roles and behaviors for people of the two sexes in their given society/culture. Since it is defined socially it isn't really a biological feature, although just like in some species the female is more likely to raise the children and etc human societal definitions of gender have mapped to some of the behavioral impulses of the different sexes. (And those behavioral impulses are why I say the differences in the sexes when looking at different species are almost entirely physical the behavioral aspect is obviously not strictly physical.)

I think it entirely possible for a healthy human brain to have a gender self-identity in contrast to the social normal. But I do not believe a healthy human brain will insist and believe, against all evidence, that their physical body is of the wrong sex because the whole concept is ludicrous. There isn't a right or wrong sex, you are the sex you were born as.

It's weird and strange for a man to dress and act as a woman, but if a man does that because of their gender self-identification, and has no desire or belief that they are "really a woman" then I don't necessarily think that person has a brain abnormality or a disorder. They're weird, a little out of sync with society, but it doesn't "seem" intrinsically abnormal in and of itself. But those people are a far cry from the ones who insist the only way to be normal is to mutilate their genitals.

The hallmark of psychiatric disorders is they cause functional problems, and that is why I can see someone who just likes to dress as a woman being fine and someone who wants to have their penis removed and their pubic region mutilated to give the illusion they are women as having a disorder.

There is a long history of homosexuals being subjected to cruel treatment, abuse, and even being sent to prison for their actions. That is wrong, homosexuality while I believe it should be considered a sexual disorder in the DSM to this day, does not harm outsiders and appears to be mild enough that people with the disorder can mostly live productive and happy lives if allowed to do so. For that reason mistreatment of homosexuals is wrong, but because of this historical mistreatment homosexuals have formed a "community of the oppressed" and have extended that community to include people with GID.

Because homosexuals (understandably) are hyper-sensitive to mistreatment and abuse and discrimination, the ones who are active in "LGBT" issues will be prone to insist that under no circumstances can you think of someone with GID as having something "wrong" with them. These people (and you are obviously one of those people) would probably rationally recognize GID is a psychiatric disorder but you feel that doing so is somehow incompatible with your view on rights for all LGBT people.

I have no such bias, I think it is clearly a psychiatric disorder but I also don't feel any of these people should be mistreated or discriminated against. It is not a violation of anyone's rights as an individual to tell them the truth: they are not a woman, they are a man. It isn't a violation of anyone's rights or even immoral to say "I hope we can find a cure for this affliction some day." Especially since I'm not saying "deny them SRS", I'm saying I consider SRS to be like a wheelchair. It works, but it's not ideal.

[ChangBo]

I really don't think they should be considered mentally ill. I just wish that gays and lesbians had a category without all the rest!

[david_42]

I spent a decade in the S.F. Bay area, so I saw a fair number of transgendered folks, pre- and post- The ones that were happy were the majority. They talked about being women (just didn't meet many F2M) and how they loved it. They rarely talked about their pre-condition. The unhappy ones almost always talked about being transgendered, even post-op. They were obsessed with being transgendered and I doubt anything could have made them happy. Yes, those folks had a mental problem.

[Ruby Slippers]

Originally Posted by adaher

Funny looks is one thing. Actually causing females to feel threatened by a male is a case where women's rights and transgendered rights come into conflict.

I don't understand this one. First of all, let me say that I wouldn't automatically feel threatened if a man entered the ladies room while I was in there. My first assumption would be that he had made a mistake. My second assumption would be that the mens room was unavailable and his need was urgent. I would only feel threatened if there was something in his demeanor that suggested a threat.

That being said, if I as a woman see another person who appears to be a woman, who is acting like a woman (whatever that means!), then I'll accept that person as a woman. I don't know what that person might have in his or her underwear and I don't want to know. Any more than I know whether this female-appearing person has intimate relations with a man or a woman. It's none of my business.

Why would I feel threatened unless the other person was holding a weapon and giving me a menacing look? And if that was the case, I'd probably feel threatened regardless of their real or assumed gender.

[Una Persson]

Originally Posted by Martin Hyde

I'd agree with that, actually. I'd be shocked if there was a template for "male" and "female" brains, but I'm not the one who wants to say a variation in trans men's BSTc means "they are men with female brains." Do you think there might be a reason none of the researchers who have looked into the BSTc abnormality in M2F transexuals has ever stated "the subjects appear to have been men with female brains?"

If there's a continuum of brain morphologies, then when do you stop feeling comfortable referring to someone's brain as female?

Now, I think homosexuality is a problem as many homosexuals have a variety of problems. Namely they clearly have sexual dysfunction and delude themselves that various acts with people of the same sex is a form of sexual intercourse when we've evolved to reproduce by having sexual intercourse with the opposite gender.

They "delude themselves" that they're having sexual intercourse? Really?

Homosexuals also often have various emotional and mood problems along with depression.

So do cisgendered people. There is no compelling reason I've seen to treat it differently in LGBT folks.

...I think we should be looking into treatments and cures for homosexuality or at the very least let's understand what combination of genetic or developmental conditions leads to the affliction so we can eventually eliminate it in future generations.

So basically, a roundabout eugenics program to eliminate LGBT?

However you refuted my specific statement that "I was glad to see Cecil acknowledge GID as a mental illness" by saying "I think he was too pessimistic and my eighteen research articles show this."

No. Please review the thread. You posted this, and my refutation is contained in the quote below, from Page 1.

Originally Posted by Una

It's your opinion he looked at it without bias. My opinion is he was overly pessimistic. I offered 18 citations in a post up above which provide support for my opinion.

The brunt of Cecil's answer was with respect to treatment of transsexuals, not the cause or validity of GID et al.

So on the subject of treatment, I've more than addressed that with my lengthy post. I'm not researched enough to debate the root cause and existence of GID at this juncture. Thus I referred you to the articles because I don't have the time to review all of them again and focus on the cause/validity of GID. That's not dismissal of you, that's saying before I get into that subject I need to do some more legwork, and perhaps you can look into it yourself. I believe the topic is addressed in at least a few of the papers, but it is not a primary focus of them.

It's simply not a honest position to tell me "well, what I'm asserting might be in one of those articles which are superficially about treatment but not about the definition of GID as a psychiatric disorder, but I'm not going to indicate which ones might hit on that and instead insist you fork over money and read all eighteen articles." I'm sorry but no, you presented those arguments to support a claim before I ever posted in this thread: that Cecil was pessimistic about success rates of treatment for GID. If you now want to say those articles also support another claim, that GID isn't a psychiatric disorder then you need to actually give some justification for that and specify exactly which articles support that assertion.

I'm sorry, but no right back at you. Where did I make the assertion? I quoted what you and I posted above. My post only addressed treatment success, which was the key point of Cecil's column.

This should clarify things.

[foolsguinea]

Originally Posted by adaher

No, RICHARD, you are a boy who likes dresses and pink. There's nothing wrong with that. So stop trying to cut off your own penis!

Yeah, I'm inclined to agree. It's more consistent to make a hard and fast rule that body dysmorphia and identification with the "other" is, well, nuts--whether it's cross-phylum, cross-species, cross-race, or cross-gender--then to say some cases are OK and some aren't.

But it's like Cecil said. Someone who undergoes sex reassignment surgery is not harming themselves to the same degree as someone who cuts off their forearms for some loony reason.

But here's an analogy for you: Someone who has surgery to change his eyelid shape, or bleaches his skin, out of identification with another ethnicity or race, isn't even doing himself as much physical harm as SRS would. But, there's a difference between saying, metaphorically, "I was a Norwegian trapped in a Vietnamese body," and actually believing that you were always a literal Norwegian trapped in a "false" Vietnamese body. At some point, yeah, there's some break with reality, and that should be acknowledged, even if it makes some people unhappy.

[don't mind me]

The concepts of "mind" and "brain" have been used interchangeably in this thread and in opposition to the physical. I would point out that the brain is physical, an organ of the body as much as genitalia. If DNA, genitals, breasts, length of femur, circumference of pelvis, etc. can all vary between sexes and within the same sex, why not the brain?

[grude]

Originally Posted by Una Persson

That fact that you believe homosexuality is a mental illness (quoted above), despite what the current DSM-IV says, means that you are in opposition to established practice in the psychological field, doesn't it?

---------------------------

And the DSM has been wrong in the past, changing the classification of homosexuality. Relying on the DSM for this argument is starting on a shaky foundation.

I was shocked to find out that the World Health Organization classified homosexuality as a mental illness up until 1990!

http://en.wikipedia.org/wiki/Homosex...and_psychology

And the shift in the 70s was due more to activists and protests than the kind hearted nature of psychological associations, I've seen a more in depth article on the declassification and there was considerable pressure from outside the field.

I don't think it means much either way what the DSM says as psychology/psychiatry is as subject to social pressure and bias as any field(I don't believe homosexuality or transexuality are mental illnesses).

[kayT]

I think this from Broomstick deserves repeating:

Castration anxiety.

That's why some many arguments about this subject get littered with phrases like "amputation" and "cutting off the penis" when, as I have pointed out, many transsexuals never get the genital-alteration surgery. Transsexuals seem much more concern with altering their appearance to trigger a response socially and can be content with looking like their "brain gender" in clothing than what is or isn't in their pants. Cissexuals focus in on OMG GENITAL SURGERY!!!!

Also, saying "chop off his penis" is ignorance at work. These days, it's much more like they turn the penis inside out, retaining as much of the sexual nerves as possible so the transsexual can potentially enjoy having sex.

On top of which - you can see the fear because this all focuses around the penis - no mention of breast implants, feminizing the face with surgery, and so on. Nor do these folks seem overly concerned with the "bearded ladies"/transmen. Apparently no one gives a damn if a woman "turns into" a man, but it's the horror of a man becoming a woman!....

Let's just say lots of people have some issues about sexuality, and not just transsexuals.

[grude]

Originally Posted by kayT

I think this from Broomstick deserves repeating:

Anyone ever find it odd that at least in the USA at the same time a lot of the public freaks out at the idea of genital surgery, they also would wade through a lake of lava to make sure their male infant is circumcised?

[Jragon]

Originally Posted by Broomstick

Castration anxiety.

That's why some many arguments about this subject get littered with phrases like "amputation" and "cutting off the penis" when, as I have pointed out, many transsexuals never get the genital-alteration surgery. Transsexuals seem much more concern with altering their appearance to trigger a response socially and can be content with looking like their "brain gender" in clothing than what is or isn't in their pants. Cissexuals focus in on OMG GENITAL SURGERY!!!!

Also, saying "chop off his penis" is ignorance at work. These days, it's much more like they turn the penis inside out, retaining as much of the sexual nerves as possible so the transsexual can potentially enjoy having sex.

On top of which - you can see the fear because this all focuses around the penis - no mention of breast implants, feminizing the face with surgery, and so on. Nor do these folks seem overly concerned with the "bearded ladies"/transmen. Apparently no one gives a damn if a woman "turns into" a man, but it's the horror of a man becoming a woman!....

Let's just say lots of people have some issues about sexuality, and not just transsexuals.

I don't know if this is directed to me/all people in this thread talking about the "mental illness" aspect. But I want to say that I was talking either way. The way I understand it F2M is pretty bad too, having longer recovery time and being generally more complicated to pull off convincingly. Though maybe I have it backwards, I always confuse them.

It's mostly just easier to stick to talking about one because otherwise every post contains a laundry list of every possible procedure in the interest of becoming "inclusive."

Also, breast implants are such a common procedure I'm kind of meh about them, they're just not as complicated as severely altering a piece of the body. I didn't know that there was a such thing as face alteration surgery that would make the face more masculine/feminine, however, I always wondered if they did something like that.

[Martin Hyde]

Originally Posted by Una Persson

If there's a continuum of brain morphologies, then when do you stop feeling comfortable referring to someone's brain as female?

Well, even the researchers doing the brain studies talk about male and female brain. Primarily because that term can simply mean "the brain inside a biological female's body", so realistically I'd never stop using the term in that sense. But that doesn't mean I think there is a totally unique signature that 100% defines a female brain versus a male brain.

So basically, a roundabout eugenics program to eliminate LGBT?

Not like historical eugenics, which invariably involved extreme discrimination and abuse. However it's only logical that now, in the 21st century and going forward as we get better and better at genetic testing and even perhaps human genetic engineering we would eliminate undesirable traits.

You can now, as I'm sure you know, test for down's syndrome and most mothers who receive positive tests choose to abort. This isn't immoral, but a simple recognition that if they are looking at giving birth to a significantly handicapped child it simply makes sense to not allow that child to exist but instead to try again.

Mental abnormalities contrary to normal function like GID and homosexuality would quickly disappear if we could test for them, no doubt about it.

No. Please review the thread. You posted this, and my refutation is contained in the quote below, from Page 1.

Then I'll just say you're confused about what my intention was. I have nothing to say really about treatment, not particularly interesting to me. I was just noting I was happy that Cecil avoided the bias mostly seen on these boards and correctly labelled GID as not just a "lifestyle" but an illness.

So on the subject of treatment, I've more than addressed that with my lengthy post. I'm not researched enough to debate the root cause and existence of GID at this juncture. Thus I referred you to the articles because I don't have the time to review all of them again and focus on the cause/validity of GID. That's not dismissal of you, that's saying before I get into that subject I need to do some more legwork, and perhaps you can look into it yourself. I believe the topic is addressed in at least a few of the papers, but it is not a primary focus of them.

Fair enough, then we have nothing to really discuss, I wasn't intending to wade into the treatment debate as I was genuinely not very interested in that aspect of it.

[Scathach]

If someone had breast enhancement surgery, would you be equally caught up in arguing that they shouldn't be fighting the biological reality of their smaller breasts?

Frankly, I have no opinion either way on whether gender dysphoria is a mental illness or not. Studies appear to show that the best treatment (in terms of reduced suicide rates & depression) is gender reassignment surgery, and really that's all that matters. I really don't see why "biological reality" is such a bugbear for people. Gender is a very complicated topic, and I don't find it wholly unreasonable that someone could have a more "female" brain in a more "male" body. Just as intersex people aren't binary male/female in that their reproductive organs don't fall within a clearly defined male/female boundary, it seems reasonable enough that brains could fall on a similar spectrum.

I think Broomstick hit the nail on the head, in that peoples instinctive reaction to surgery on the genitals seems to be disgust for whatever reason. Breast enhancement or a nose job is more accepted, but just as the thought of height increasing surgery (which involves breaking the knees and inserting a wedge which is increased in width gradually) triggers my wince reflex, so too does the thought of genital surgery for many people.

[kayT]

I certainly don't agree that homosexuaity would disappear if it could be "tested for" nor that it is "undesirable." And in case it matters I am not homosexual.

[Martin Hyde]

Originally Posted by Scathach

If someone had breast enhancement surgery, would you be equally caught up in arguing that they shouldn't be fighting the biological reality of their smaller breasts?

People have breast enhancements to satisfy their vanity, I don't believe they have a genuine delusion that they are "a larger breasted woman in a smaller breasted woman's body." That's why it's a total non-sequitur and has no place in a discussion about psychiatric disorders like GID or other types of dysmorphia.

Frankly, I have no opinion either way on whether gender dysphoria is a mental illness or not. Studies appear to show that the best treatment (in terms of reduced suicide rates & depression) is gender reassignment surgery, and really that's all that matters. I really don't see why "biological reality" is such a bugbear for people. Gender is a very complicated topic, and I don't find it wholly unreasonable that someone could have a more "female" brain in a more "male" body. Just as intersex people aren't binary male/female in that their reproductive organs don't fall within a clearly defined male/female boundary, it seems reasonable enough that brains could fall on a similar spectrum.

No one that I've seen is saying not to do surgery. But if your position is that we shouldn't be looking into research for alternatives, that's like telling paraplegics, "you have wheelchairs, why should we even bother looking for long term cures to spinal cord injuries??"

I think Broomstick hit the nail on the head, in that peoples instinctive reaction to surgery on the genitals seems to be disgust for whatever reason. Breast enhancement or a nose job is more accepted, but just as the thought of height increasing surgery (which involves breaking the knees and inserting a wedge which is increased in width gradually) triggers my wince reflex, so too does the thought of genital surgery for many people.

Yes, people are disgusted by things, but that has nothing to do with whether or not GID people have a psychiatric disorder. Science says they do.

[Broomstick]

Whether it's a "psychiatric disorder" or a "birth defect" I think the end goal here is to alleviate suffering to the extent we are able to do so. It's all very well to go on about how, as an analogy, a wheelchair isn't an ideal solution to the problem of spinal cord injury but the fact remains it's the best solution we currently have and to deny that to people is needlessly cruel. At present what do we have to offer a transsexual? Endless therapy which won't cure, only give them "coping skills" which may or may not be adequate? Sexual reassignment treatment which is admittedly imperfect? Really, what else is there? Those are the two choices open to them at present, those are likely to be the only choices for the foreseeable future. Nattering on about how great a "real cure" in the brain (or whatever) would be is pointless when you're faced with a human being suffering right now, today, this minute.

Sure, discussing genital surgery is disturbing. So is the notion of taking a liver out of a dead person and stitching it into a live person but we now do that routinely. A LOT of medicine, when you really think about it, is creepy/disgusting/unnerving... even horrifying.

Again, I say what is most important here is taking dysfunctional, suffering people and making them as happy and functional as possible. It doesn't matter how that state came to be, whether genetic, psychiatric, hormonal, or whatever. If that entails something I, personally, might find disturbing or disgusting, well, maybe I should just suck it up a little for the sake of my fellow human being. After all, I only have to deal with it for the brief period of time I am with that person - they have to deal with and suffer their condition 24/7, 365, with no time off, forever. I don't have to understand their mental state, or even be particularly happy with their situation or how they handle it, but I do owe them, as a fellow human being, some effort to not make their lives harder.

[Krokodil]

I'm hesitant to judge or make generalizations here; transsexuals are struggling with a problem I don't have and it's difficult for me to relate. I've known quite a few over the years, though, and a few things about them really stand out:

--The transsexuals I've known, I've met through my involvement in theater and comic books. They are drawn to fabulism and fantasy to a much greater degree than other people.

--They are, on an individual level, incredibly disorganized. This could explain why, despite their high representation in literary and creative fields, there is no organized movement or school of transsexual artists or writers.

--This is the one that gets me: They are not attracted to each other. M-to-F transsexuals I've met tend to be attracted to women, but only to those of the born and bred variety.

There's evidence of a problem here, but just not quite enough to do much about it.

[Una Persson]

Let me respond to some of these things in a way which is not meant to be argumentative, but to provide a different viewpoint. And give me a convenient excuse to editorialize.

Originally Posted by Krokodil

--The transsexuals I've known, I've met through my involvement in theater and comic books. They are drawn to fabulism and fantasy to a much greater degree than other people.

IME this seems to be true, but then I've never seen it carried out in a negative way. Most transsexuals I know are heavy into Sci-Fi and fantasy, but in the nerdy way, not the "I've lost touch with reality way." An example would be a recent party of t-girls I went to where the hottest debate topics were Firefly versus the rest of the Sci-Fi world, and which Doctor Who was the best. Many of them are involved in Renn Faire, but not because they see themselves as a gypsy dancer or fairy princess, but because for some it was one of the first ways it was socially acceptable to cross-dress. The same with ones I know in the theatre. Transsexuals IME tend to be highly creative and somewhat eclectic in all things.

--They are, on an individual level, incredibly disorganized. This could explain why, despite their high representation in literary and creative fields, there is no organized movement or school of transsexual artists or writers.

On an individual level...I'm not sure. I can't comment that I've noticed any difference relative to anyone else. On a group level transsexuals have a big problem which lesbians and gays do not - for many, or most transsexuals, there is an ultimate goal of leaving the group. A lesbian doesn't think "someday I will no longer be gay," but a trans woman thinks "someday, after SRS and legal work, I'll no longer be trans" and when they do either transition completely or else learn to pass so well it makes no difference, then they tend to leave the group, cutting off ties with long-term friends to start an independent life. Many describe life as three-phases: "first I was a boy, then I was trans, now I'm a woman and all the rest is behind me." I've known a few who within 6 months after SRS and getting their gender markers changed dropped cold-turkey almost all their friends, trans or not, because they wanted to live a quiet, ordinary life as a woman, not as a transwoman. And it's very painful for their friends when this happens - everyone wants to see and is cheering on someone who achieves that goal, but they also know when that person does achieve it, they likely will never see them again. I find that very sad.

And that may be desirable for the individual, but it's a big problem for the community and activism, when its most successful and well-adjusted members who do transition fully are steadily dropping out.

--This is the one that gets me: They are not attracted to each other. M-to-F transsexuals I've met tend to be attracted to women, but only to those of the born and bred variety.

From what I understand from many deep, heart-to-heart conversations, they usually are not attracted to each other because they tend to view others in the community as being sisters or brothers, rather than friends. Transsexuals have often had to endure psychological trauma and abuse, and physical abuse and trauma, which would floor the average person. At a recent trans and lesbian party I went to, very late at night the conversation turned sober and the topic went around this large table of women of who had been raped - and guess what, every single person at that table had been raped at least once, some multiple times. Most had experienced physical abuse or been attacked, every one had experienced mental and emotional abuse, and pretty much everyone had suffered from job discrimination or were in imminent danger of losing their job.

One can then say "well, lesbians and gays are an oppressed group," but the problem is the level of oppression which lesbians and gays face pales next to that which transsexuals face. Transsexuals live in a world where they are placed in the lowest caste of society. They can be made fun, parodied, and abused in ways which few would ever think to do to any other minority group. I've seen polls where 6 of 10 American adults have said they feel "unsafe" around transsexuals, and 9 of 10 would be too terrified to let their children be taught by a trans teacher. I've also seen polls where fully 1/3 of LGB folks say they would not ever want to be associated with that embarrassing "T," and even locally here in my parochial city, it's not hard to find such things as lesbian women's activities to which no, transwomen, no matter how well they may or may not pass, are not welcome. And some gay men are very hostile towards transmen, resorting even to physical abuse. On this message board on the 12 years I've been here I've seen several prominent posters who otherwise seem intelligent and reasonable people curl their electronic lip in open disgust at transsexuals, usually to the silent approval of the majority of members here.

Those sorts of shared painful life experiences create a very tight (yet sadly temporary) bond which makes you tend to see other transsexuals as part of your family, rather than dating material. That having been said, I have known transsexuals who have dated each other, and had successful relationships, it's just very rare.

[PetW]

Una, do you think that early sexual abuse has a potential to cause transexuality?

[Una Persson]

Originally Posted by PetW

Una, do you think that early sexual abuse has a potential to cause transexuality?

I have not researched that specific subject, but my gut feel is that there is little to no connection. Let me explain why my gut thinks this.

A significant number of children and teens are raped or sexually abused, and yet the prevalence of transsexuals in the United States is still somewhat rare, between 1 in 3,000 to 1 in 10,000 for transwomen, and between 1 in 10,000 to 1 in 30,000 for transmen (it's very difficult to get solid numbers due to the fear of exposure and the desire for "deep stealth").

Most transwomen I speak to have had their sexual assaults happen in their mid-late teens, when they started expressing a different gender identity and someone decided to take advantage of that, or punish them for it (and on an aside, one really has to wonder about the extremely crippled mental state of a homophobic male who is so homophobic they resort to committing homosexual rape to punish a transwoman.) Most transwomen speak of having their gender dysphoria manifest well below that age, typically from age 4-8).

And although I haven't looked into that topic specifically, from what I can recall of the research I've read on the subject, I'm not recalling that as being strongly pushed as a cause. I have seen editorializing that because transpeople behave outside of gender norms for their birth sex, they could attract the attention of pedophiles and sexual predators, who may be more likely to molest or rape a willowy boy with long hair, than a pumped-up testosterone-laden soccer jock. In addition, transgendered youth may give off body-language and verbal signals of submissiveness, confusion, and uncertainty, which may then paint a giant virtual target on them of "this is someone I can molest and they're less likely to fight back and definitely won't tell anyone."

So I'm not dismissing that it could be a cause in some cases, or a trigger, but I'm not thinking it's likely.

[DocCathode]

Originally Posted by PetW

Una, do you think that early sexual abuse has a potential to cause transexuality?

I agree with Una. Besides all else, I've seen a few studies that prove we can reliably cause transexedness in rats and mice by manipulating a mother's hormones during pregnancy. Although no such experiments have been done on humans, I think that we're looking at a very similar cause.

[PatriotGrrrl]

I recall seeing studies that girls who were born late in their mother's lives (and thus exposed to a different that usual ratio of hormones in utero) are likely to be androgynous or butch, if not necessarily transgendered.

[Martin Hyde]

Originally Posted by Broomstick

Whether it's a "psychiatric disorder" or a "birth defect" I think the end goal here is to alleviate suffering to the extent we are able to do so. It's all very well to go on about how, as an analogy, a wheelchair isn't an ideal solution to the problem of spinal cord injury but the fact remains it's the best solution we currently have and to deny that to people is needlessly cruel. At present what do we have to offer a transsexual? Endless therapy which won't cure, only give them "coping skills" which may or may not be adequate? Sexual reassignment treatment which is admittedly imperfect? Really, what else is there? Those are the two choices open to them at present, those are likely to be the only choices for the foreseeable future. Nattering on about how great a "real cure" in the brain (or whatever) would be is pointless when you're faced with a human being suffering right now, today, this minute.

Sure, discussing genital surgery is disturbing. So is the notion of taking a liver out of a dead person and stitching it into a live person but we now do that routinely. A LOT of medicine, when you really think about it, is creepy/disgusting/unnerving... even horrifying.

Again, I say what is most important here is taking dysfunctional, suffering people and making them as happy and functional as possible. It doesn't matter how that state came to be, whether genetic, psychiatric, hormonal, or whatever. If that entails something I, personally, might find disturbing or disgusting, well, maybe I should just suck it up a little for the sake of my fellow human being. After all, I only have to deal with it for the brief period of time I am with that person - they have to deal with and suffer their condition 24/7, 365, with no time off, forever. I don't have to understand their mental state, or even be particularly happy with their situation or how they handle it, but I do owe them, as a fellow human being, some effort to not make their lives harder.

I'm assuming you are just talking to the thread at large, since nothing you've said in this post has anything to do with anything I've said.

I will note that "birth defect" and "psychiatric disorder" are not necessarily mutually exclusive.

[Tethered Kite]

A contributing factor?

http://www.google.com/search?q=x+cha...ter+supply&rls

[Powers]

Originally Posted by Doctor Why

That's fair enough, but why assume that the mental one is right? Why is clinical depression an issue of errant brain chemistry, but gender dysphoria isn't?

Perhaps it is. But we do not have effective chemical treatments available.

We "assume" the mental one is right because a) we can change the physical more effectively than we can change the mental, and b) because one's mental state is a key component of self-perception. In most cases, someone who views himself as a man would not want to be made to view himself as a woman. It would completely change the way he see himself, and probably would make him feel like he was discarding a part of himself. Conversely, such people tend to see sex reassignment surgery as corrective.

With depression, there is nothing physical to change; the only way to treat it is by changing the way someone thinks -- either via therapy or chemistry.


Powers &8^]

[elucidator]

In the statement, "I am a woman trapped in the body of a man", who or what is the "I"? Doesn't the statement imply a separate but indwelling identity? A "soul", then? Was this being "there" at birth, as we typically think of a soul? How separate is this being?

When philosophy and/or metaphysics and/or spirituality rub up against science, it generally works to the disadvantage of both. When we cannot "know" the answer, it is important that we accept that and stop looking, due to threat of finding the "answer", when we know there isn't one.

Let it be, and judge not. For myself, the notion that one has an identity that is at variance with one's body is an absurdity. But if someone cannot live, cannot function, cannot partake in life because they believe that this is so, let's just do what we can. We can surely counsel caution, we can warn that once you go down the Road of the Scalpel, there is no turning back.

But if they are already miserable, and sincerely believe that this form of mutilation will render them capable of a reasonable life, well, why the hell not? If they don't have a life now, what are they risking?

Out of billions and billions of people, just about every possibility is realized. There simply has to be some people who will have the surgery, and have a near miraculous experience. There also has to be people who will have it and be worse off than they were.

We can improve our surgical techniques. We can improve our understanding of sexuality and brain functions. We may find that there is a malfuncton in some of these case that is treatable and reversible by non-drastic means. All of his we can do.

But we cannot ever know if there is a soul with an identity within a body. The "I" that Descartes talks about. Let it be. Not our call to make.

[Measure for Measure]

Originally Posted by Blake

What always mystifies me is that it is such a huge issue. It's impossible to say of course, but I have always thought that if I woke up tomorrow and found out that, as a result of a well studied biological process, I was in a woman's body I would come to accept it. I would be freaked out to hell initially of course, and the doctors may have to explain to me what has happened and that there is no way to change it a lot of times before I would believe it.

Ditto. But Una explained to me some years back that a sense of gender varies among people. There are ultra-macho guys (not me) and ultra-femme babes. There's no conceptual reason why somebody couldn't combine a head from one extreme with a mis-matched body.

Originally Posted by Una Persson

I disagreed with Cecil's conclusions in this column. He and I had very many conversations over how to interpret the problem of high drop-out rates.

FWIW, the response rates that Cecil reported didn't seem too low to me-- they seemed rather typical. If I understand your posts correctly though, it seems that even determined (and expensive) followup by researchers might not track down a high share.

Originally Posted by Broomstick

That said, I'm not entirely convinced this is a mental illness.

Well, depression wasn't always a coded medical condition: Lincoln suffered from melancholy, but he wasn't considered crazy at the time. The trend is towards the increasing medicalization of the human condition. So calling this stuff a mental issue isn't a huge leap.

On castration anxiety: that has to play a big role. There are very good evolutionary reasons for men to protect their genitalia, so it's not surprising that these inclinations would bleed off into other attitudes.

Originally Posted by Una Persson

In addition, I have direct personal experience working with transsexual counselors and transsexuals, and I have never met anyone who regretted their surgery or hormone treatment (although I have met a couple who did have unsatisfactory surgical results). One counselor I know has helped more than 300 individuals fully transition and to the best of her knowledge, not a single one regretted hormones, surgery, or the entire process.

While I'm interested in reported self-satisfaction with surgery, that doesn't seem to me to be the only relevant metric. It's a difficult to reverse procedure that we're discussing after all and not the sort of thing to which one would want to admit an error in judgment. So I found other metrics salient (eg an increase in finding a partner). I guess I'm wondering whether 3rd parties (friends, families) believe the life of the TS has improved. It seems that your informed anecdotal impression is yes.

Nice presentation of the research, btw.

[Ruby Slippers]

[quote=Krokodil;15399623]I'm hesitant to judge or make generalizations here; transsexuals are struggling with a problem I don't have and it's difficult for me to relate. I've known quite a few over the years, though, and a few things about them really stand out:

--The transsexuals I've known, I've met through my involvement in theater and comic books. They are drawn to fabulism and fantasy to a much greater degree than other people.

QUOTE]

I'd like to add to Una's response to this point. I've attended quite a few Star Trek conventions and one of the things I've noticed is that the con audiences seem to have a much higher percentage than the population at large of folks I would characterize as "outcasts." Many are severely overweight, socially maladapted, or at least just generally geeky. (I'm not casting aspersions. I most definitely count myself in this group.) Sci fi cons appeal to us on a couple of different levels -- they are set in a different reality, not the one that judges us and finds us wanting, and thus, as mostly outcasts from the rest of society, we tend to be more accepting of each other's flaws, issues, and shortcomings.

In other words, transsexuals may not be drawn to these venues because of something about their makeup, they may be drawn to them because they find a greater degree of acceptance among kindred souls.

[gamerunknown]

Originally Posted by Martin Hyde

Namely they clearly have sexual dysfunction and delude themselves that various acts with people of the same sex is a form of sexual intercourse when we've evolved to reproduce by having sexual intercourse with the opposite gender.

Naturalistic fallacy. Hilarious, by the way. Will science also eliminate all forms of irrumatio, masturbation, fellatio and contraception, since these all contravene the divine evolutionary edict of fecund fornication?

Edit:

Originally Posted by elucidator

We can surely counsel caution, we can warn that once you go down the Road of the Scalpel, there is no turning back.

Not strictly true.

[Irishman]

Originally Posted by Mijin

You're shifting this to make it as though transsexuals are requiring you to do some action. I've seen no example of this.

If a transsexual really did want you to force you to make some public acknowledgement, I'd be on your side. But I've never seen it.

Well, there is some level of forced acknowledgment, even if of a passive form. Use of pronouns, not freaking/protesting/etc to their choice of restroom, etc. That's a far cry from expecting you to join the Trans Parade, carry a banner, and cheer, but it is a level of public acknowledgment.

Originally Posted by Powers

Gender is a mental construct; sex is a physical construct. When the two don't match, who is to say that the physical one is right and the mental one is wrong?

Well, I can understand when comparing a purely physical construct like genitalia vs a purely mental construct, one might wish to give precedence to the physical - expecially when talking about someone else's mental constructs. The question is if the mental construct does not have roots in a different physical construct, i.e. brain structure/chemistry. And if it does, then which should be given predeminance?

One challenging question just might be if identity stands apart from something like schizophrenia, or bipolar disorder, where we acknowledge the brain chemistry is significant but also disfunctional. If we're willing to call brain chemistry disfunctional in one case, why not in another case? Whether that is transgenderedness, or homosexuality?

Originally Posted by Doctor Why

That's fair enough, but why assume that the mental one is right? Why is clinical depression an issue of errant brain chemistry, but gender dysphoria isn't?

Perhaps it is, but there isn't an easy way to adjust the chemistry back into balance, because we cannot yet identify what is out of balance?

Originally Posted by gamerunknown

Here is the proposed revision in DSM-5.

Thanks. Note that I had to specifically look for the "Rationale" tab for the discussion. I overlooked it at first, and wondered about all the double asterisks.

Originally Posted by Martin Hyde

Now, I think homosexuality is a problem as many homosexuals have a variety of problems. Namely they clearly have sexual dysfunction...

Dysfunction? Their equipment is working properly.

... and delude themselves that various acts with people of the same sex is a form of sexual intercourse when we've evolved to reproduce by having sexual intercourse with the opposite gender.

Yeah, because none of the acts homosexuals do are ever performed by heterosexuals. Or are you trying to argue that the only sex we should be having is for reproduction, and nothing else? Does that include masturbation?

Okay, I will grant you that masturbation isn't really sexual intercourse, mostly because if fails on the grounds of "inter" and "course".

Homosexuals also often have various emotional and mood problems along with depression.

And how much of that is because they are homosexual, vs because they are people? And of the amount associated with their homosexuality, how much of that is derived from social factors, i.e. acceptance by family, stress with employers, etc?

But those people are a far cry from the ones who insist the only way to be normal is to mutilate their genitals.

Hyperbole noted.

I have no such bias, I think it is clearly a psychiatric disorder but I also don't feel any of these people should be mistreated or discriminated against. It is not a violation of anyone's rights as an individual to tell them the truth: they are not a woman, they are a man. It isn't a violation of anyone's rights or even immoral to say "I hope we can find a cure for this affliction some day." Especially since I'm not saying "deny them SRS", I'm saying I consider SRS to be like a wheelchair. It works, but it's not ideal.

I understand what you are saying. And even in the case of things like bipolar disorder that are attributable to brain chemistry imbalances, it's not quite a simple fix. There's plenty of finding the right meds and right dosages, and then there are other problems with keeping on the meds.

But suppose for a moment we did find some biochemical system that could account for the condition, something that could be treated by meds. Then it becomes a real issue to discuss whether a person is ill and should try treatment for the biochemical state, or if they should be preserved how they feel and the body changed to fit.

Originally Posted by grude

Anyone ever find it odd that at least in the USA at the same time a lot of the public freaks out at the idea of genital surgery, they also would wade through a lake of lava to make sure their male infant is circumcised?

Yep.

Originally Posted by Una Persson

On a group level transsexuals have a big problem which lesbians and gays do not - for many, or most transsexuals, there is an ultimate goal of leaving the group. A lesbian doesn't think "someday I will no longer be gay," but a trans woman thinks "someday, after SRS and legal work, I'll no longer be trans" and when they do either transition completely or else learn to pass so well it makes no difference, then they tend to leave the group, cutting off ties with long-term friends to start an independent life. Many describe life as three-phases: "first I was a boy, then I was trans, now I'm a woman and all the rest is behind me." I've known a few who within 6 months after SRS and getting their gender markers changed dropped cold-turkey almost all their friends, trans or not, because they wanted to live a quiet, ordinary life as a woman, not as a transwoman. And it's very painful for their friends when this happens - everyone wants to see and is cheering on someone who achieves that goal, but they also know when that person does achieve it, they likely will never see them again. I find that very sad.

It is sad to think that they give up friendships. On the other hand, many people have life changes that make and break social ties. Think, for example, of growing up, moving away to college, then moving away from there somewhere else to start a career. Then getting married and moving again. Each relocation marks a physical life transition that affects relationships and friendships. It is sad, but it is a fact of life. I guess I can perceive how a person who has gone through transition would like their life to then be about their new state, and not focused on how they were.

You know how there's always someone in your social group who calls you by the nickname you had in elementary school, even though you've tried to dump it? Or always brings up stuff that happened in the past? That can be rough when those elements are all about things you want to put behind you and not constantly deal with. And also, once you're trying to pass, you don't want your new friends and acquaintances aware of your old you. You don't want them asking why you are friends with so many trans people, because it puts your identity in question. When you are trying to live as a woman, the last thing you want is people still reacting to you like a man, or a freak.

[DocCathode]

Originally Posted by elucidator

In the statement, "I am a woman trapped in the body of a man", who or what is the "I"? Doesn't the statement imply a separate but indwelling identity? A "soul", then?

No.

There is no need to bring metaphysics into this. The I you speak of resides in the brain- a brain at odds with chromosomes and genitalia.

[Doctor Why]

Originally Posted by Irishman

Perhaps it is, but there isn't an easy way to adjust the chemistry back into balance, because we cannot yet identify what is out of balance?

Originally Posted by Powers

Perhaps it is. But we do not have effective chemical treatments available.

We "assume" the mental one is right because a) we can change the physical more effectively than we can change the mental, and b) because one's mental state is a key component of self-perception. In most cases, someone who views himself as a man would not want to be made to view himself as a woman. It would completely change the way he see himself, and probably would make him feel like he was discarding a part of himself. Conversely, such people tend to see sex reassignment surgery as corrective.

With depression, there is nothing physical to change; the only way to treat it is by changing the way someone thinks -- either via therapy or chemistry.


Powers &8^]

I'm not opposed to physical treatments, and I understand that we don't have any other options at the moment; It just seemed that it was being implied that this was a physical issue because we don't have therapy or chemical treatments. I don't know too much about medicine, though, and maybe that does make it a de facto physical issue.

That's a good point about self-perception, and it cuts straight to the part that I find interesting. With disorders that we do have therapeutic and chemical treatments for, it seems standard to accept that the patient's perception is not normal and needs to be corrected. That doesn't appear to be the case here, and I find that intriguing.

[Krokodil]

Originally Posted by Ruby Slippers

I'd like to add to Una's response to this point. I've attended quite a few Star Trek conventions and one of the things I've noticed is that the con audiences seem to have a much higher percentage than the population at large of folks I would characterize as "outcasts." Many are severely overweight, socially maladapted, or at least just generally geeky. (I'm not casting aspersions. I most definitely count myself in this group.) Sci fi cons appeal to us on a couple of different levels -- they are set in a different reality, not the one that judges us and finds us wanting, and thus, as mostly outcasts from the rest of society, we tend to be more accepting of each other's flaws, issues, and shortcomings.

Oh, agreed. My observations about other undercaste-types need to be qualified with "...says the fat white guy who reads comic books."

[Una Persson]

Originally Posted by Doctor Why

I'm not opposed to physical treatments, and I understand that we don't have any other options at the moment; It just seemed that it was being implied that this was a physical issue because we don't have therapy or chemical treatments. I don't know too much about medicine, though, and maybe that does make it a de facto physical issue.

That's a good point about self-perception, and it cuts straight to the part that I find interesting. With disorders that we do have therapeutic and chemical treatments for, it seems standard to accept that the patient's perception is not normal and needs to be corrected. That doesn't appear to be the case here, and I find that intriguing.

Part of the problem is that transsexuals generally cannot be "cured" by psychotherapy or antidepressants or other medication. In the same manner that being lesbian or gay cannot be "cured."

Now it is true in all the aforementioned cases there will be some people who may be close enough to straight or cisgendered on the respective sexual preference and gender spectrums that they can cope and lead a "normal" life. But generally speaking, the efficacy of psychotherapy for transsexuals is via coping strategies, not a cure. I mean, it filters down like this:

* Start with a group of transgendered persons of size A.

* Some portion of A are close enough to central on the gender spectrum that they can cope, if they want to, with forcing their birth and mental genders to be the same. call that group "B". This group seems to be very small.

* Of the remaining group (A-B), some portion, called C, will be able to cope with their transsexuality via counseling, group therapy, and coping strategies. This group is modest in size.

* Of the remaining group (A-B-C), some portion, called D, will be able to cope with their transsexuality via hormone treatments. In some cases only anti-androgens are used. In other cases low-dose estrogen is used. But in most cases, anti-androgens and high-dose estrogen is used. This group is fairly large in size, I believe it is the largest group.

* Of the remaining group, (A-B-C-D), some portion, called E, will be able to cope with their transsexuality via SRS. This group is also fairly large in size.

* Finally, a small number of the remaining group (A-B-C-D-E), called F, will still be unable to cope, and will require some serious psychological intervention. This group appears to be very small.

If one wanted to be as cautious as possible, proceeding to anti-androgens alone appears to be a fairly "safe" process. While anti-androgens may lead to gynecomastia and could result in prostate disorders, they will not radically change the body like high-dose estrogen will. And some transsexuals are quite happy on anti-androgens alone. The rest...need to walk further down that hard road.

[Measure for Measure]

Originally Posted by grude

Anyone ever find it odd that at least in the USA at the same time a lot of the public freaks out at the idea of genital surgery, they also would wade through a lake of lava to make sure their male infant is circumcised?

No not at all. I find it odd that anybody wouldn't freak at least a little about genital mutilation (sorry, I don't know the proper word that encompasses turning a penis inside out but that sets aside the rather small and hygienic aspect of snipping an infant's foreskin). Don't get me wrong: I assume that the transgendered don't have recreational sex re-assignment surgery, just as triple bypass patients don't look forward to their ordeal. Surgery of all sorts is freaky, cock and ball surgery especially so.

Males also find the Candiru fish to be the stuff of nightmares and instinctively feel inclined to protect their groin when it is described.

Originally Posted by Una

If one wanted to be as cautious as possible, proceeding to anti-androgens alone appears to be a fairly "safe" process.

Do you have any anecdotal or scientific evidence on the share of transexuals who try hormone therapy and then give it up, reverting to group B or C? I'm thinking of those who do it out of preference rather than financing.

[vikinghorn6]

The answer to the question is simple, elegant, and carries the weight of law. Secular and religious law. And of course the bylaws of the medical profession. Yes, a transgendered person in any area of their journey are by definition mentally ill. We are now only speaking of those humans born XX or Xy as the vast majority of humans are. For the record we are aware that there are others who are born with conditions leaving them somewhere in between. Those who through no fault of their own, as accidents of birth, were given both sexual organs of each of the sexes. Leaving these people truly trapped and faced with certain choices, or non-choices to be made. But right here, right now, we are speaking of transponders. Who were given one body, male or female. One otherwise healthy body through which to go through life. There are some people, transponders , who are unhappy with their bodies sexual equipment, and subsequent hormones. They look like men, but feel like women in their hearts, and brains. The question was, is this way of feeling mentally ill or normal for certain people. The question clearly has an answer in the DSM IV. Which classifies this belief and thinking as a mental illness. There are those, to be sure, who will argue that the publication has been wrong before and could be again? I'll save you the suspense they are right. It's been wrong many times and no doubt will be again, just not today! Today, wanting to mutilate your body in order to match a misguided vision in your head of what you should look like is wrong. So wrong that it is a decease.I know, it's not that simple. Michael Jackson had many mutilating surgeries to look more like the one gloved picture in his head. And so did his whole family evidently. I myself just spent $17500 getting my teeth capped to fool the world into thinking that I have young beautiful teeth. We all do it a bit. Rogaine, steroids, spin classes, botox, lasic surgery, face lifts, breast augmentations, it's a $200 billion a year business. Making the best of what we have. But transgendered is different for one really big reason. The afore mentioned treatments are to accentuate, or make the best of what has been given to us naturally. Transgendered Fails the sanity tests because the sufferers wish to have a mulligan on their whole body. The want a do over with all new equipment. That's not just neurotic, not just vain, not just narcissistic, but crosses over to mentally I'll. But why? Scream the tree hugging,liberals? Because no matter what you do the change will never be complete. You can lop off body parts, add them, or reform them. And with a butt load of hormones you maybe can get to a passing familiarity to the sex you are going for. But no matter how many surgeries, no matter how many collagen shots, no matter how many make up tricks you learn, your chromosomes are fighting you and winning every single day. Chanell#5 doesn't change the XY chromosome pairs in every cell in your body. And one day, when there are no more surgeries, no more Botox shots, no more $ for hormones, you are still a man. The coroner will describe you as a post op woman, but a genetic man. Therefore he checks the male box. A whole life of pain, shame, surgeries, botox, collagen, waxings, and god knows what else, you are either a man or a woman, and you aren't fooling a soul except for yourself. So IMHO if you have thoughts that make your appearance as a male or female repugnant to you. And you find it necessary to spend all of your time, money, and goodwill, getting your sexual assignment changed, cuz it doesn't jive with your view of yourself. You have a mental illness and you should explore all the treatments avaiable in that vein before you begin lopping off body parts and going to silicone parties. Just my humble opinion.

[wanfuforever]

Greetings. I am a male in a relationship with a MtF transgender. We have been together for 12 years, so suffice it to say I have had more contact with the TG population than most. First, we have to understand what we are speaking of is a taboo in the West. It is a threat to "reality" as perceived by many, but part of the reason for science is to challenge our assumptions. What has been found is that the hypothalamus, which supports and drives the endocrine system (something quite important to sex and gender) has been shown to act as the gender TG's feel they really are. In the end, what is in your brain trumps the body parts. Most people have mind-body agreement, but about one in thirty thousand do not. The problem is, because of societal pressures such as acceptance and "false positives" i.e. people that are more transvestites than transgender, it makes the understanding of the situation difficult. Most TG's don't want to be TG's, and many take on (oh, we'll keep this to MtF's which seem to be the ones that grab attention) super masculine roles almost in the attempt to prove to themselves their own masculinity, but come to terms with themselves later in life though many admit to feeling "different" at an early age.
It always fascinates me that society acts as though the male gender is the default gender. I go to restaurants where the waitresses wear ties as part of their uniform and no one views it strange. A woman in a commercial can wear her husband's clothes and it's considered "cute" she's thinking of her man. Men wearing feminine clothing is constantly used as a comic effect. It is my assertion that the hostility towards transgenders is twofold: xenophobia, and the fear of emasculation. See for reference http://www.gender.org/remember/about/core.html. The sad part is many men want to have sexual relations with TG's, this just don't want to be seen with one. I know escorts that make in two days what it takes me two weeks to make. People that make $600 then go to lunch. But the same people will slam TG's to go along with the group rather than admit their attraction. It's rarer to find me willing to state it publicly than to find transgenders themselves.
The "mental illness" portion is a bit loaded. It conjures people that do not function in society, have a complete lack of mores etc. and from first hand experience that is a perception that simply is not true. Is there something happening that is very rare in their brains? Yes. Is it something that is totally debilitating that should make people go on full panic alert? No- but that's what is going to happen. We hold no illusions because it is a very tough pill to swallow. Of all things, gender should be simple and clear, right? Unfortunately, things are more muddled than we ever suspected.

[Doctor Why]

Originally Posted by Una Persson

Part of the problem is that transsexuals generally cannot be "cured" by psychotherapy or antidepressants or other medication. In the same manner that being lesbian or gay cannot be "cured."

I get what you're saying, but for the sake of argument, what's the definition of "cured"? There are mental disorders that require constant medication for the rest of the patient's life. Is that cured? What would it take for a transgendered person to be called cured?

Also, thanks for the breakdown. I guess what I really wonder about is whether we'll be able to devise more effective treatments in the future and affect the respective size of those groups. I suppose the question of whether this is a physical or mental problem can be revisited if we do.

I'm also wondering, what do we currently do for that last group who don't even feel better after surgery?

[AHunter3]

Incidentally I just finished watching "Becoming Chaz", the story of Sonny & Cher Bono's kid's transitional experience. It's something you should all consider seeing.


What do people mean when they say "mentally ill"? If anyone in this thread who is responding "yeah they're mentally ill" would care to elaborate, are you asserting that "holding this belief about themselves is a reliable indicator that there is a chemical or neurological brain dysfunction at the biological level"? (That is what psychiatry touts as the definition of "mental illness") That doesn't seem like a defensible hypothesis without a shitload of data that no one is citing but I'd like to hear your evidence on that.

Or perhaps you mean it metaphorically / less literally, e.g., "holding this belief about themselves means that the things they believe can be discredited as nutty thoughts". If that's what you mean, that doesn't sound like legitimate discussion tactics to me. How is that different from "If you believe this, you are WRONG because that's just so wrong it's WRONG so you're WRONG"?

[Broomstick]

One of the things I find irritating in such discussions as these are people like vikinghorn6 who seem almost gleeful to point out just how sick and delusional transsexuals are. Funny thing, though - I have never met a transsexual, in real life or on the internet, who ever denied the at-birth configuration of their genitalia, or had the notion that SRT would somehow change their chromosomes, or that it would perfectly replicate a particular gender's body. In that sense, at least, they are NOT delusional. They are very aware that their physical bodies are NOT want their mental genders are, that is in fact the source of their distress.

Originally Posted by vikinghorn6

The answer to the question is simple, elegant, and carries the weight of law. Secular and religious law.

No, it doesn't. First of all, religious law should only apply to practitioners of the particular religion. Imposing "religious law" on someone outside that religion is an affront to human rights and should be seen as so ridiculous as to cause laughing fits in those who have evolved beyond mystical superstition. Second, the secular law in a lot of places allow the legal change of gender on records for post-op transsexuals, up to an including amending birth certificates. Please correct your ignorance on these matters.

Yes, a transgendered person in any area of their journey are by definition mentally ill.

Strictly speaking, the psychiatric profession considers everyone mentally ill to one degree or another, or at least having the mental sniffles, as we all have hang-ups, issues, and petty delusions we live under. It's a matter of degree, not a binary is/is not situation.

For that reason, the criteria for whether or not someone needs treatment isn't "do they have a problem/delusion/issue?" but does it interfere with their ability to function in life? Some with a severe phobia in regards to flying in an airplane doesn't require treatment unless that phobia in some way impairs their ability to function. If the person has no need or desire to fly somewhere then no treatment is necessary. On the other hand, someone who flies as a necessary part of their job might seek treatment for a mild anxiety about flying.

Given the extraordinarily high rate of self-harm and suicide among the transgendered, this would seem to be an area where treatment is needed. As already noted multiple times, our options are limited. We can't change their brains/minds. We can change their bodies, albeit imperfectly. Right now, the question is does SRT actually improve their situations or not?

No one, including transsexuals, is denying that their situation is unusual or dysfunctional. No one is happy to be a transsexual. There really is something wrong. That's why transsexuals seek treatment and often times spend enormous amounts of money on treatments they know won't "cure" them, only, if they're fortunate, relieve some of their suffering and distress.

Those who through no fault of their own, as accidents of birth, were given both sexual organs of each of the sexes.

That's not how intersex conditions usually work. If you need to learn the facts about intersex conditions I suggest you start here

There are some people, transponders , who are unhappy with their bodies sexual equipment, and subsequent hormones. They look like men, but feel like women in their hearts, and brains. The question was, is this way of feeling mentally ill or normal for certain people.

First: these people are not "transponders". They are "transsexual". There is no need to make up new terminology when we have perfectly adequate words already. Particularly when "transponder" is already in use with a different meaning.

Second: no one is suggesting that transsexuality is "normal". It's not. Transsexual people are painfully aware they are not normal. The issue isn't whether or not they're normal, it's what to do about their condition. I'd argue that their condition does not in any way justify the abuse they all too routinely suffer, it does not justify discrimination in housing, employment, or access to medical care, and it doesn't justify other humans treating them as shit. They are human beings and deserve to be treated as such, and not as second-class (or worse) citizens.

I myself just spent $17500 getting my teeth capped to fool the world into thinking that I have young beautiful teeth. We all do it a bit. Rogaine, steroids, spin classes, botox, lasic surgery, face lifts, breast augmentations, it's a $200 billion a year business. Making the best of what we have. But transgendered is different for one really big reason. The afore mentioned treatments are to accentuate, or make the best of what has been given to us naturally.

Incorrect again.

Yes, there are a lot of instances where dentistry and cosmetic surgery is used to enhance or alter rather than restore function, but BOTH of those categories of medicine originated in restoring function, not changing appearance. You might have gotten your teeth capped to make them more beautiful. A former co-worker of mine got hers capped to repair the damage done by an abusive former husband. I've known several people who got extensive dental work not for vanity but to repair the damage caused by accidents, by jaw cancer, and other things.

Steroids have a role in helping burn patients heal. Spin classes aren't "fake", they're real exercise that really improve health. Botox is used to treat cerebral palsy and was originally approved to treat eyelid muscle spasms that caused functional blindness. The techniques used in face lifts were pioneered to treat burn victims and facial deformities. Breast implants are used to restore a more normal contour after cancer surgery. Everything you mention is used not just for vanity but also for real medical problems that cause real suffering.

So, once again, the situation is not as binary as some people would like. The categories smear together. The world is more complex than small minds would like.

Because no matter what you do the change will never be complete.

They know that.

But, by that rationale, we shouldn't allow women who've undergone mastectomies to have breast reconstruction surgery because the new breasts will never be "complete", they will always be obviously fake once the clothes come off, with visible scarring, in many cases with either no aureola or nipple (unless a crude approximation is tattooed on). They aren't real, those women are just fooling themselves, and when they wear clothes they're trying to deceive everyone else. We shouldn't fix cleft palates because, you know, 80 years later when an autopsy is performed the person doing it will be able to see the surgical scars and know this person has lived a "lie" of having a normal, functional mouth all their life instead of an approximated restoration.

You can lop off body parts, add them, or reform them. And with a butt load of hormones you maybe can get to a passing familiarity to the sex you are going for.

Actually, for MtF these days they can be pretty damn convincing, even with their clothes off. Unless you're routinely performing pelvic exams on your acquaintances and/or bed partners you're not going to notice. I am certain, given human nature, there are people out there carrying speculums into their bedrooms for sex play but the average person isn't looking that closely.

But no matter how many surgeries, no matter how many collagen shots, no matter how many make up tricks you learn, your chromosomes are fighting you and winning every single day.

This causes my mind to generate a puzzling image. Really? The chromosomes are "fighting"? The little Y's stand up every morning and pummel the transsexual person and slap her around a bit before breakfast? What, exactly, do you mean by that?

The coroner will describe you as a post op woman, but a genetic man. Therefore he checks the male box.

Actually, there are many jurisdictions where a post-op transsexual really is legally a woman, and therefore the box will be marked "female" with a note of "post-op transsexual".

When I worked at a clinic, way back in the dark ages of the late 20th Century, all of the MtF transsexual files were kept with the other women's files, their records were marked as "female", they used the female facilities when they need to pee or poo, they were addressed as women by the staff, and the only time it came up was either during gynecological exams or when asked "when was the last time you menstruated?", the answer being "I don't, being a transsexual".

Yes, some medical people - far too many if you ask me - will snigger in private at the sad transsexuals under their care, but it would HIGHLY unusual for medical people to go around telling transsexuals they're "really" this or that to their face. They may not agree with how it's treated, but then, medical people face stuff far, far worse than what transsexuals do to their bodies. Genital surgery under a competent doctor is pretty damn tame compared to what some people will do in the way of self-harm. If you don't know what I'm talking about consider yourself blessed.

A whole life of pain, shame, surgeries, botox, collagen, waxings, and god knows what else, you are either a man or a woman, and you aren't fooling a soul except for yourself.

Actually, they're NOT fooling themselves. I've yet to meet a transsexual who has forgotten that they were born a man (in the case of MtF) or a woman (for FtM). They remember every day when they take their required hormone pills. They remember because you don't forget a miserable childhood/teen years. They're not delusional in that sense, they really do know and understand they have extensively modified the body they were born with.

They DO "fool" a lot of other people. I've met transsexuals that completely pass as their chosen gender. I'm certain I've met a lot more of them who I didn't know were such, because it's not a topic for casual conversation. I'm certain that YOU have met women who were born in male bodies that you'll never know underwent transition.

I think you, and a lot of other people, fear that you will be "fooled". Sure, we all see the middle-aged transitioning men-into-women who, unfortunately, will always look like a man in a dress to one degree or another. You don't see the one that transitioned in her early 20's, before a lifetime of testosterone exposure, who looks more authentically female than many women who were born as women.

And, by the way, thanks for lumping in every woman who uses botox, collagen, waxes her legs, shaves, or "god knows what else" into the mix. You do realize you just called about 95% of women delusional and attempting to fool, right? What next? Make up is the practice of witchcraft? Or do you think the average woman doesn't have body hair and doesn't use make up?

You have a mental illness and you should explore all the treatments avaiable in that vein before you begin lopping off body parts and going to silicone parties. Just my humble opinion.

Again, you display your ignorance. Transsexuals are required to undergo years of therapy prior to an irreversible changes (assuming they go through legitimate medical channels - some don't of course, but there are plenty of non-transsexual people who go to "silicone" parties". Such as this girl, Vanity Wonder)

You say they should "explore" all treatments available - how do you know they DON'T? Other than they make, in the end, a choice you find repugnant? No one gets SRT on a whim. No one. It's a multi-year process at best.

[Una Persson]

Originally Posted by Measure for Measure

Do you have any anecdotal or scientific evidence on the share of transexuals who try hormone therapy and then give it up, reverting to group B or C? I'm thinking of those who do it out of preference rather than financing.

I do, but I hesitated to post it because it was anecdote. Nonetheless, since you inquired, the only ones I knew who tried hormones and gave it up did so because they had serious, serious money problems, or one lady who gave up estrogen because it was produced from animal products, and being a vegan (I think) she didn't feel good using it. Reading the literature I have read of transwomen who quit due to the pills making them ill, or causing extreme mood swings which were causing self-destructive behavior. The vast, vast majority who I know who have taken anti-androgens alone or anti-androgens and estrogen together report enormous improvements in mood, attitude, self-esteem, and overall general health. And I have read of folks online who report being on hormones for half a year or more, feeling that it wasn't "right" for them, and quitting.

But if I had to place numbers on it...going from my gut, not citations....I'd say 95%+ are very happy and see serious improvements on hormones, and are still taking them.

[Una Persson]

Originally Posted by Doctor Why

I get what you're saying, but for the sake of argument, what's the definition of "cured"?

I mean "no longer suffers from gender dysphoria as a result of psychotherapy alone." But note I originally put "cured" in quotes because I firmly believe that there isn't really a "cure" which is needed in the first place.

I'm also wondering, what do we currently do for that last group who don't even feel better after surgery?

From the literature I have reviewed, in most cases that group had an additional serious psychological problem which was undiagnosed, and probably should have had better screening before they got to that point. Also, we need to differentiate a couple of things in what I say - some women are unhappy even after full SRS because they still don't pass, and are still ostracized and abused. It's a painful fact that a 6'4" woman with size 15 shoes is going to immediately attract all eyes to her and lead to a lot of close scrutiny as far as "can she be...is that...OMG..." Whereas transsexuals who are, oh, for argument sake 5'5" and 130 pounds, with slight features and narrow limbs, were passing before without even trying. Whatever the case, that unhappiness is not necessarily a surgical failure, but it does represent the cold, hard fact that SRS and hormones will only change body morphology by so much. In an ideal society it wouldn't freaking matter, but for the present...it's an issue.

[kayT]

Just want to say thanks to Broomstick and Una Persson for the wonderful job of fighting ignorance here. I hope those who badly need this information are still reading.

[Powers]

Originally Posted by AHunter3

If anyone in this thread who is responding "yeah they're mentally ill" would care to elaborate, are you asserting that "holding this belief about themselves is a reliable indicator that there is a chemical or neurological brain dysfunction at the biological level"? (That is what psychiatry touts as the definition of "mental illness") That doesn't seem like a defensible hypothesis without a shitload of data that no one is citing but I'd like to hear your evidence on that.

I don't know how much evidence it needs... From observation, the vast, vast majority of people experience a perception of their own gender that matches that of their biological sex. For that to be reversed in one direction or the other does seem like it would have to result from an error or malfunction in the person's development at some point in time. If it were otherwise, we would expect to see it much more often, wouldn't we?


Powers &8^]

[Powers]

Originally Posted by Doctor Why

That's a good point about self-perception, and it cuts straight to the part that I find interesting. With disorders that we do have therapeutic and chemical treatments for, it seems standard to accept that the patient's perception is not normal and needs to be corrected. That doesn't appear to be the case here, and I find that intriguing.

Well, I think it's simple... it's because the "abnormality" is not abnormal at all, if you look at it in isolation. Someone who thinks she is a woman is not abnormal; over half the population of the planet thinks the same way. That is not an abnormality. The only thing that would be "abnormal" is if the woman's chromosomes were not XX, but that in itself does not make her perception abnormal.

For a mental disorder like schizophrenia, on the other hand, we can see that it's clear the person's thought processes are not human-typical. His or her mind is operating in such a way as to be a danger to him- or herself and to others.


Powers &8^]

[Una Persson]

Originally Posted by vikinghorn6

The answer to the question is simple, elegant, and carries the weight of law. Secular and religious law.

I'm less than impressed by what Bronze Age goatherders felt about transsexualism...which IIRC isn't mentioned in the Bible at all, other than the admonition about wearing the wrong clothing.

But right here, right now, we are speaking of transponders. Who were given one body, male or female. One otherwise healthy body through which to go through life. There are some people, transponders , who are unhappy with their bodies sexual equipment, and subsequent hormones.

Transponders? Really? Forgive me if this implies a certain lack of attention to detail, lack of knowledge, or both.

There are those, to be sure, who will argue that the publication has been wrong before and could be again? I'll save you the suspense they are right. It's been wrong many times and no doubt will be again, just not today!

Well, you've convinced me.

Chanell#5 doesn't change the XY chromosome pairs in every cell in your body.

No, for that you need Prada. Ask me how I know...

The coroner will describe you as a post op woman, but a genetic man. Therefore he checks the male box.

Thankfully most folks don't live their lives trying to look their best for their coroner. "Does my liver look fat on that stainless steel scale?"

You have a mental illness and you should explore all the treatments avaiable in that vein before you begin lopping off body parts and going to silicone parties. Just my humble opinion.

1) The most effective treatment for transsexuals at this time is partial or complete transition. This is the widely-accepted treatment by the medical establishment in many, if not most countries.

2) Describing the delicate and typically highly effective procedure of SRS as "lopping off body parts" pretty much is the code words for "transsexuals are icky." And silicone parties have little to do with transsexualism. I don't even know where to start with that one.

Really, Broomstick rebutted most of your points better than I.

[Doctor Why]

Thank you, Una.

Originally Posted by Powers

Well, I think it's simple... it's because the "abnormality" is not abnormal at all, if you look at it in isolation. Someone who thinks she is a woman is not abnormal; over half the population of the planet thinks the same way. That is not an abnormality. The only thing that would be "abnormal" is if the woman's chromosomes were not XX, but that in itself does not make her perception abnormal.

For a mental disorder like schizophrenia, on the other hand, we can see that it's clear the person's thought processes are not human-typical. His or her mind is operating in such a way as to be a danger to him- or herself and to others.


Powers &8^]

I sort of follow, but I still don't get it. Surely it is normal to hear voices, but is abnormal to hear voices with no discernible source that tell you to perform violent acts?* To me it seems improper to look at the perception in isolation. To put it another way: It's pretty normal to go skiing, right? But it wouldn't be normal to think that you're skiing when you're sitting at your desk unless you've just eaten a peppermint patty.

*I know that schizophrenia is so much more than just auditory hallucinations and that they aren't always violent.

[Mellifluous]

So, I have a question as a bisexual, intersex, transwoman. When do I have the right, assuming I had the audacity, to publically debate the validity of anyone else's identity and their right to live their lives in an authentic manner? Now, with all due thanks to theose who are supportive and work hard to Quixotically bludgeon the trolls with things like facts, and I do thank you from the bottom of my heart, but placing us under some public microscope is unwanted, unnecessary, and insulting.

I have no idea what it is to be a straight male, despite the conditioning that my parents duly imposed upon me. I cannot presume to make decisions for or parse the motivations, intentions, and decisions of them, because I am not one. Nor can I assume that they are monolithic in any way. And yet they stand all around me, pointing, debating, insulting as if I were not there much the same as happens to women and people of colour and other so-called minorities.

Go away already! Debate things which pertain to you, and leave me and my ilk well out of your judgements. Now, try that with the rest of the world, and throw in some fuzzy-warm feelings of fairness and equality, and BOOM!, there's world peace. Back to reality, though, for those who cannot believe in a reality any different than what they can experience, try seeing in the infra-red with your naked eye, try smelling a danish from a mile away - underwater, try unaided flight and navigation by feeling the subtle variations of our planet's magnetic field. What? Can't be done? No, because it is not within your ability to. I am not suggesting that we are different species, but that there are aspects of the greater reality that you can not experience, and may seem wildly impossible, but are nevertheless very real for those who do experience them. Just accept it and move on. Nobody wants to take YOUR penis off (but if you keep talking like a fool it might not sound like a bad idea), so be happy for that, and move on.

[DocCathode]

Originally Posted by kayT

Just want to say thanks to Broomstick and Una Persson for the wonderful job of fighting ignorance here. I hope those who badly need this information are still reading.

I second this.

[DocCathode]

If you woke up tomorrow in the body of the opposite sex, how would you feel? What would you be?

If I took your brain out and kept it alive in a jar, what would you be then?

If I removed all grey and white matter from your skull except for enough brain stem to keep your lungs breathing and your heart beating, would you be alive or dead?