# Are Transsexuals Mentally Ill?
**URL:** https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759
**Category:** Cecil's Columns/Staff Reports
**Created:** [August 17, 2012, 9:13am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759 "2012-08-17T09:13:00Z")
**Posts on this page:** 20
**Page:** 12
### Author:  [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)
#### Post date: [September 9, 2012, 8:12pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/221 "2012-09-09T20:12:07Z")
> [@Dr.Strangelove](#):
>
> The analogy might fall apart had the author not likened femininity itself to a handicap–but that view seems required for the dialogue to be compelling in the first place.
Correct. I think that Serano makes a legitimate point in her work; as a result of the early feminists femininity has been seen to be a handicap at best and a form of volunteering for male oppression at worst. The mistaken belief that to be strong, independent, forceful, and equal meant you needed to take on those aspects of masculinity. The point is to be _femininely_ strong, not _masculinely_ strong, etc.
> [@](#):
>
> I don’t see how it’s supposed to work on the “unconverted masses”.
I’m not sure if the unconverted masses can be easily converted. Certainly one essay means nothing to the sort of person who every time they read about transsexuals surreptitiously drops their hands to their penis to check it’s still there, and who feels that they need to hoot and cheer at Jerry Springer any time “My Husband is a Tricked-out Tranny!” is the topic. Or the woman who is so terrified that someone might witness her in a bathroom stall with x-ray vision that she crosses her legs before getting up from the toilet.
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### Author:  [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)
#### Post date: [September 9, 2012, 8:58pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/222 "2012-09-09T20:58:22Z")
> [@Una\_Persson](#):
>
> The mistaken belief that to be strong, independent, forceful, and equal meant you needed to take on those aspects of masculinity. The point is to be _femininely_ strong, not _masculinely_ strong, etc.
To be honest, I have no idea what that means. I know plenty of strong willed women who are undoubtedly feminine, but their forcefulness seems orthogonal to their sex. Obviously we have to get over the “sexually independent woman = slut” view, but I think that’s counter to what you said: it means we need a common view of what it means to be sexually independent.
> [@Una\_Persson](#):
>
> I’m not sure if the unconverted masses can be easily converted. Certainly one essay means nothing to the sort of person who every time they read about transsexuals surreptitiously drops their hands to their penis to check it’s still there, and who feels that they need to hoot and cheer at Jerry Springer any time “My Husband is a Tricked-out Tranny!” is the topic. Or the woman who is so terrified that someone might witness her in a bathroom stall with x-ray vision that she crosses her legs before getting up from the toilet.
Sure. There are probably a lot of those people, and the best we can hope for there is that they’ll die off over time and the new generation won’t have so many. The way I see it, the ones with a purely emotional response aren’t going to be swayed by a different emotional appeal. The rest–maybe a small population, but non-zero–can be swayed by evidence. The best evidence we have is that sex reassignment works better than the alternative, and that until we know more we should go with what works best.
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 12:44am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/223 "2012-09-10T00:44:23Z")
> [@DocCathode](#):
>
> If ignoring evidence and dodging questions is ‘doing something right’, then you sure are!
What evidence do you claim I ignored?
Is giving an answer to a question ignoring it? I’m sorry if you didn’t like the answer to your extremely theoretical question.
I, didn0t get any answer for my hypothetical one.
> [@Broomstick](#):
>
> For other types of body image problems alternatives to surgery have a much higher chance of alleviating suffering, thus, surgery is not justified. It is perfectly justifiable to attempt less invasive interventions before more invasive.
So, we agree that surgery is an option.
Thanks
> [@](#):
>
> There would have to be one hell of a benefit to amputating working fingers to justify such an action. It’s all about risk and benefit. No one here is recommending surgery for transsexuals because surgery is such a wonderful thing, it’s because there are few or no viable alternatives for some people.
>
> Once again, there is too much focus here on genital surgery. MANY transsexuals never get their genitals altered, and it is most certainly _not_ required. ALL transsexuals contemplating gender reassignment therapy _must_ undergo extensive counseling (at least they do in western nations) so it’s not like anyone is proceeding directly to the operating room. Quite a few undergo counseling and hormone therapy, learn to pass in clothing, and are able to be content with that even if it’s still not a perfect situation. No one is _forced_ to undergo genital surgery. It is an option, not a mandate for treating a distressed transsexual. If an individual wants to stop short of that – and there are people who fall into that category – they are welcome to do so and should be supported in that decision.
>
> One reason female to male transsexuals are less likely to undergo genital surgery is because the outcomes for constructing a penis are less wonderful than those for constructing a vagina. Thus, there is less benefit for the risks involved.
So, again we agree that surgery is an option, with the proper safeguards.
Agreed that maybe, at least in my case, too much enphasis was given to surgery.
> [@](#):
>
> If we can’t cure or even alleviate the underlying condition then symptom control is entirely appropriate. If, in the future, we come up with alternatives we’ll revisit the question, I’m sure, but _right now_ all we have is symptom control. As I mentioned, surgery is NOT the first thing considered or offered, even for transsexuals.
>
> We can’t cure arthritis, we treat the symptoms. We can’t cure asthma, so we treat the symptoms. We can’t cure multiple sclerosis, so we treat the symptoms. We can’t cure diabetes, so we treat the symptoms. We can’t cure transsexuality, so we treat the symptoms.
Agreed, especially since you accept that
a) transsexuality is a disease
b) We treat it but no cure it.
Which are, by the way, my points.
[/QUOTE]
Actually, there _is_ still a role for surgery in the treatment of mental illness. It is rare, and there are tons of hoops and red tape to get through for approval these days, but in _severe, intractable, and life-threatening cases_ it can be considered as an option. You have to exhaust all other options first, of course. It _does_ help some people but the risks are high. Also, these days it’s not an icepick through an eyesocket, it’s much more finely targeted.
Keeping in mind that untreated transsexuality may have a suicide risk of 1/3, extreme measures might be justified.
[/QUOTE]
Agreed on both counts.
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 1:05am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/224 "2012-09-10T01:05:51Z")
> [@Aji\_de\_Gallina](#):
>
> What evidence do you claim I ignored?
Cites showing that the human brain is sexually dimorphic for starters.
> [@](#):
>
> Is giving an answer to a question ignoring it? I’m sorry if you didn’t like the answer to your extremely theoretical question.
I’m sorry my questions were too theoretical for you. Here are two simple ones-
Are you a man or a woman?
How do you know?
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 1:19am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/225 "2012-09-10T01:19:49Z")
> [@DocCathode](#):
>
> Cites showing that the human brain is sexually dimorphic for starters.
I fully accept that certain areas of the brain are sexually dismorphic.
> [@](#):
>
> I’m sorry my questions were too theoretical for you. Here are two simple ones-
> Are you a man or a woman?
>
> How do you know?
Man; penis, XY, children.
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 1:37am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/226 "2012-09-10T01:37:56Z")
> [@Aji\_de\_Gallina](#):
>
> Man; penis, XY, children.
The following questions are not theoretical
Is some one born XY, penis, but infertile a man?
Is some one born XY but with no penis a man?
What about some one born XXY, penis infertile?
XYY penis, infertile?
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 2:24am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/227 "2012-09-10T02:24:35Z")
> [@DocCathode](#):
>
> The following questions are not theoretical
>
> Is some one born XY, penis, but infertile a man?
>
> Is some one born XY but with no penis a man?
>
> What about some one born XXY, penis infertile?
>
> XYY penis, infertile?
Yes
Man
Klinefelter means man
Man
I’m neither a doctor nor a biologists so I’m more than ready to be corrected on the scientific validity of my informed opinions.
I’ll stop answering you quizzes until you answer mine
Hemispherectomy, two bodies, Two men?
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 2:31am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/228 "2012-09-10T02:31:18Z")
> [@Aji\_de\_Gallina](#):
>
> I’ll stop answering you quizzes until you answer mine
>
> Hemispherectomy, two bodies, Two men?
I’ll answer if you can explain the relevance of your question to the topic of this thread.
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 2:39am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/229 "2012-09-10T02:39:39Z")
> [@DocCathode](#):
>
> I’ll answer if you can explain the relevance of your question to the topic of this thread.
Didn’t you ask:
> [@](#):
>
> If I transplanted your brain into the body of a woman, what would you be?
>
> If I transplanted your brain into a chimpanzee, what would you be?
>
> If I kept your brain alive in a jar, what would you be?
So, it is as relevant as those.
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 2:43am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/230 "2012-09-10T02:43:55Z")
> [@Aji\_de\_Gallina](#):
>
> Didn’t you ask:
Yes, I did.
> [@](#):
>
> So, it is as relevant as those.
No, it isn’t.
I asked questions to determine your views on body vs brain when determining identity. I thought you would see that. It seems you do not.
You then ask a question on a tangent to mine. It is not related to the topic of this thread.
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 2:52am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/231 "2012-09-10T02:52:48Z")
> [@DocCathode](#):
>
> Yes, I did.
>
> No, it isn’t.
>
> I asked questions to determine your views on body vs brain when determining identity. I thought you would see that. It seems you do not.
>
> You then ask a question on a tangent to mine. It is not related to the topic of this thread.
Brain-in-a-jar is relevant and two-hemispheres in different bodies isn’t?
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 2:55am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/232 "2012-09-10T02:55:34Z")
> [@Aji\_de\_Gallina](#):
>
> Brain-in-a-jar is relevant and two-hemispheres in different bodies isn’t?
Yep.
A brain with no body cuts to the heart of brain vs body.
Two hemispheres in different bodies addresses what issues raised in this thread? Left hempisphere vs right?
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 3:02am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/233 "2012-09-10T03:02:16Z")
> [@DocCathode](#):
>
> Yep.
> A brain with no body cuts to the heart of brain vs body.
> Two hemispheres in different bodies addresses what issues raised in this thread? Left hempisphere vs right?
Locus of identity.
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### Author:  [@DocCathode](https://boards.straightdope.com/u/DocCathode)
#### Post date: [September 10, 2012, 3:05am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/234 "2012-09-10T03:05:16Z")
> [@Aji\_de\_Gallina](#):
>
> Locus of identity.
Nice try. Where in this thread has the issue ‘Where in the brain is identity?’ been raised.
OTOH the issue of ‘is sexual identity in the brain or in the body?’ has been raised multiple times.
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### Author:  [@Skypist](https://boards.straightdope.com/u/Skypist)
#### Post date: [September 10, 2012, 7:13am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/235 "2012-09-10T07:13:45Z")
> [@Learjeff](#):
>
> Bottom line: it’s not just a MENTAL ILLNESS. It’s an internal conflict disorder. Genitals are one sex, brain is another. Which is right?
This makes it sound like if being transgender can be shown NOT to be a mental illness, then it is more valid, more real, more of a “physical” disability than being mentally ill (and therefore the request to be viewed as the opposite sex of their biological gender should be honored). But mental illness often is correlated with chemical changes or physical malformations in the brain, environmental causes, and genetics. For instance, this link states that research shows these various causes for schizophrenia: Genetics, prenatal exposure to a viral infection, low oxygen levels during birth, exposure to a virus during infancy, early parental loss or separation, and physical or sexual abuse in childhood. Many of those factors are every bit as “real”/physical as the possibility that a transgender person was exposed to the “wrong” hormone for their physical gender before birth.
[http://www.helpguide.org/mental/schizophrenia\_symptom.htm](http://www.helpguide.org/mental/schizophrenia_symptom.htm)
> [@Irishman](#):
>
> As far as I am aware, there are not a string of hormonal triggers that activate during development that define whether you are a space man (or a dragon or Napoleon). So that is one solid distinction for transgenders.
No, not a space man or a dragon or Napoleon, but definitely there are physical triggers that might give someone a mental illness that made them THINK they were a space man or a dragon or Napoleon.
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### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 10, 2012, 6:10pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/236 "2012-09-10T18:10:56Z")
> [@DocCathode](#):
>
> Nice try. Where in this thread has the issue ‘Where in the brain is identity?’ been raised.
>
> OTOH the issue of ‘is sexual identity in the brain or in the body?’ has been raised multiple times.
## Ok, just so you won’t get upset. Two hemispheres, one goes to a male boy one goes to a female body.
In the end, my point, my real point is that it is clear that transsexuality is a disease and therefore treated/treatable.
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### Author:  [@Irishman](https://boards.straightdope.com/u/Irishman)
#### Post date: [September 10, 2012, 9:26pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/237 "2012-09-10T21:26:30Z")
> [@Dr.Strangelove](#):
>
> Your post raises good questions but I don’t see how the bolded part is relevant. This thread is about sexual identity, not sexual orientation. Conflicts in one or the other or both may exist in a given person.
I think in the context of some of the attitudes displayed by **stevenova** that comment is right in line with his thinking. But you are correct, genetalia do not define sexual orientation any more than they define sexual identity.
> [@](#):
>
> I myself do have a hard time imagining how sexual identity could be so important to warrant surgery. I think: suppose I woke up one day with my genitalia swapped. An alien announces to me that the conversion is perfect, and my new equipment works as well as anyone’s. Further, the brains of my friends and family have all been subtly altered such that not only do they accept my new identity, but they believe my identity is what I have always been. My SO still loves me and I am told that childrearing will not be a problem (via unmentioned means).
>
> About the only emotion I can conjure up is supreme annoyance. But I’m pretty sure after a while I would just go with the flow. It wouldn’t take that long to figure out which bathroom to go to. I doubt I could ever be a “girly girl”, but I’m fairly certain I could pass easily enough and quickly reach the point where I no longer thought about it much.
I just don’t think this grasps the essence of what it is to be told your whole life, from your earliest memories, that you are messed up, that everyone sees you differently than you see yourself. It’s one thing to take a whole person who has a relatively stable identity and then subject them to a change, it’s another to fiddle with the very formative process of shaping who you are.
I am certain if I found myself in that situation I would find a way to cope, but it is not nearly the same thing.
> [@](#):
>
> Of course, I’m not trans, so I just can’t really say. I just wonder if there’s a spectrum of how tied people are to sexual identity, and that trans people require not only a mental/physical mismatch, but a very strong sense of identity that amplifies this mismatch. Perhaps not everyone has this strong sense of identity.
Something to speculate on, but how would you know?
> [@](#):
>
> I also wonder how this would manifest in a world where boys doing “girl things” wasn’t looked at so harshly. For some reason, girls can act as tomboys without too much problem, but the reverse doesn’t seem to be true.
That would be a very different society, wouldn’t it.
> [@Aji\_de\_Gallina](#):
>
> Ignorance? No, not in my case at least.
So you know what it’s like to be transgender? You’ve experienced it?
> [@](#):
>
> “Downfall of society” is always a silly argument.
I’m glad you agree.
> [@](#):
>
> Aside from my wife and my kids, other people’s genitals are usually none of my business
You seem awfully concerned that someone might be cutting off some genetalia somewhere, for someone who thinks others genitals are none of your business.
> [@](#):
>
> I don’t have to get over transgendered people even if this thread is about transsexuals.
My comment was to learn to accept them in society and treat them like people. You don’t have to get over them - you can throw a little tirade every time you think about the idea someone might ask you to use a different pronoun like **stevenova** does. I’m simply stating my opinion that the world would be better if everyone got over it.
> [@Aji\_de\_Gallina](#):
>
> Very simple, sorry to have used big words.
> Sex - Biology: Men - Women
> Gender: Even though it’s supposed to be a personal construct it is always experessed along the man-woman comparison or a continuum. Why would gender nned to be along those lines?
Why shouldn’t it? Humans are naturally dimorphic, with a variety of development misfires that can trigger variances from either “ideal” state. The human brain is also a construct of the biology that forms our bodies, so is it any wonder that there are two nominal states, and a spectrum of variety for various mismatches of various degrees?
> [@](#):
>
> Bathrooms are not a cultural expectation.
What about bathrooms are not cultural? Needing to excrete waste is not cultural. Everything about having a specific room to do it in, having specific arrangements for equipment and methods (paper vs hand, bidet or not), and how we segregate is all cultural.
> [@Aji\_de\_Gallina](#):
>
> In the end, my point, my real point is that it is clear that transsexuality is a disease and therefore treated/treatable.
Some people may be oversensitive to the idea of calling transexuality a disease on the grounds of feeling judged by the ones using the term. It is fair to say that something is mixed up with transexuals, they certainly have a problem. I don’t think anyone is arguing that it does not need treatment, the disagreement seems to be over the validity of a certain treatment option.
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### Author:  [@Dr.Strangelove](https://boards.straightdope.com/u/Dr.Strangelove)
#### Post date: [September 10, 2012, 10:41pm UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/238 "2012-09-10T22:41:47Z")
> [@Irishman](#):
>
> I just don’t think this grasps the essence of what it is to be told your whole life, from your earliest memories, that you are messed up, that everyone sees you differently than you see yourself. It’s one thing to take a whole person who has a relatively stable identity and then subject them to a change, it’s another to fiddle with the very formative process of shaping who you are.
That’s a very good point. It must be deeply traumatic to spend one’s formative years with that kind of conflict.
> [@Irishman](#):
>
> Something to speculate on, but how would you know?
I mentioned earlier the case of David Reimer–a clear biological male that was raised as female due to a surgical accident. He ultimately found out his original sex and began living as male immediately afterward. Later, he committed suicide due to deep psychological trauma.
So that argues that some people have a very strong sense of inner identity. But it’s just one data point, and it’s co-mingled with other factors such as an apparently abusive psychologist.
Obviously, it’s a very good thing there aren’t more cases like David, but it does mean there’s very little data to go on.
---
### Author:  [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)
#### Post date: [September 11, 2012, 12:14am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/239 "2012-09-11T00:14:13Z")
> [@Irishman](#):
>
> So you know what it’s like to be transgender? You’ve experienced it?
Read the context. Really.
> [@](#):
>
> I’m glad you agree.
> [@](#):
>
> You seem awfully concerned that someone might be cutting off some genetalia somewhere, for someone who thinks others genitals are none of your business.
It’s a thread about transexuality and mental disease, not about 20/20 cricket. Genital surgery is bound to be discussed.
I’s also like to point out the several times I’ve said that surgery is an option.
> [@](#):
>
> My comment was to learn to accept them in society and treat them like people. You don’t have to get over them - you can throw a little tirade every time you think about the idea someone might ask you to use a different pronoun like **stevenova** does. I’m simply stating my opinion that the world would be better if everyone got over it.
Treat like people? Wherever did you get the idea that I was against it?
Different pronoun? Out of common courtesy? Sure. Conviction? No
Treating people well. Wherever did you get the idea that I was against it?
> [@](#):
>
> Why shouldn’t it? Humans are naturally dimorphic, with a variety of development misfires that can trigger variances from either “ideal” state. The human brain is also a construct of the biology that forms our bodies, so is it any wonder that there are two nominal states, and a spectrum of variety for various mismatches of various degrees?
No, it isn’t. Who said otherwise?
> [@](#):
>
> What about bathrooms are not cultural? Needing to excrete waste is not cultural. Everything about having a specific room to do it in, having specific arrangements for equipment and methods (paper vs hand, bidet or not), and how we segregate is all cultural.
What is cultural? Separate bathrooms.
> [@](#):
>
> Some people may be oversensitive to the idea of calling transexuality a disease on the grounds of feeling judged by the ones using the term. It is fair to say that something is mixed up with transexuals, they certainly have a problem. I don’t think anyone is arguing that it does not need treatment, the disagreement seems to be over the validity of a certain treatment option.
All the time here on the SDMB they tell me not to be oversensitive and stuff like that. If you particiapte here, you need thick skin, which is par for the course on anonymous boards.
Yes the argument is about treatment because the OP question if transsexual are mentally ill
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### Author:  [@Powers](https://boards.straightdope.com/u/Powers)
#### Post date: [September 11, 2012, 1:50am UTC](https://boards.straightdope.com/t/are-transsexuals-mentally-ill/631759/240 "2012-09-11T01:50:21Z")
> [@Aji\_de\_Gallina](#):
>
> Sex - Biology: Men - Women
> Gender: Even though it’s supposed to be a personal construct it is always experessed along the man-woman comparison or a continuum. Why would gender nned to be along those lines?
Your phrasing is still very odd, but I think I see what you mean. Until recently, the dichotomy between sex and gender was not well understood, so of course people often considered them interchangeable. Happily, that is now changing, no thanks to people like you who resist the change.
Powers &8^]
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