What?
RedFury dropped something equally “witty” in the IMHO poll, also.
I had a couple of paragraphs written, but I like your reply better. Indeed. :rolleyes:
Do you enjoy being hateful, or can you just not help yourself?
At a coffee shop my wife and I frequent, the men’s room broke down one day, and so a sign was placed on the door to the women’s washroom reading “The men’s washroom is unavailable today. Let’s be adults about this.”
And that day, no fucks were given.
A large factor in the Johns Hopkins involvement was due to John Money who believed that gender identification was entirely learned and in no way innate, and his promotion of the case of David Reimer as an unqualified success regarding early gender re-assignment which lead to a lot of surgery on intersex infants and ensuing heartache. John Hopkins drew back from intersex and transsexual issues when it became apparent that Money was wrong about a lot of things, and cases like Reimer’s lend weight to the notion of gender identity having a significant biological factor and not simply being a matter of environment or upbringing.
In other words, John Hopkins was at the “forefront” for specific reasons that later proved false. Those reasons were very different than those involved in adults making informed choices about what they want.
Note that that does not mean Johns Hopkins wasn’t involved, or isn’t still involved, in some surgeries for adult transsexuals, but the whole of their program was much more broad than just that.
Tensions and emotions are running high enough in this thread without attempting to make bad jokes referring to old trolls (about whom a number of participants will be unfamiliar).
Knock it off.
[ /Moderating ]
If the only difference between Caucasians and African Americans was skin color, then it would be objectively wrong to call yourself Caucasian if you are dark-skinned.
But in fact, there are LOTS of other characteristics that define race. Some black people suffer from a pigmentation problem that makes their skin white. Does that make them Caucasian? No. Some Caucasians can have darker skin than some African Americans. That does not make them ‘black’.
Can you imagine how a kid might feel if he was born into a black community to black parents, but had a skin condition that made him whiter than Phil Donoghue? Can you imagine that kid being ostracized by his parents, by his friends, by his community because he wasn’t one of them, even though inside he knew he was exactly like them? Can you imagine how he might feel every time he looked in the mirror, and how he might seek out a treatment that would give him the skin color that matches his internal view of himself so he could be accepted by the community he feels part of and be literally comfortable in his own skin for the first time in his life?
If so, you might start to have a glimmering understanding of what it’s like to be truly transgendered. But only slightly, because gender and sexuality affect us at a very deep, very primal level. For a transgendered person this mismatch can be intolerable.
There are differences between men and women that go beyond sexual preference and primary and secondary sex characteristics. I am related to someone who is a female-to-male transgendered person. I’ve known him all his life. He was never comfortable as a girl. As a young child, he would refuse to conform to gender roles. The few female friends he had weren’t close, because they didn’t relate to him and he wasn’t interested in the things they wanted to do. He wanted to do the things his male friends did, but they treated him like a girl. So he was always a bit of an outcast from both genders. He would cry if his mom put him in a dress. Over the years he became shy and introverted.
The crisis hit, as it often does, at puberty when his body started to change and he couldn’t escape the physical evidence that he was not who he pictured himself to be. Depression and other problems set in. The poor kid was totally miserable for a couple of years before finally accepting who he was and taking steps to do something about it.
He finally came out and declared that he was male, and started dressing and presenting himself to the world as male. And you know what? It became immediately obvious to everyone that he was male. The kid who was always an awkward female who never seemed comfortable in his own skin became a male who was obviously male in attitude, thinking, and other behaviors. It was clear as day. He has male friends who do not know his transgendered status, and it doesn’t occur to them to think that he’s anything but male. He’s not effeminate or ‘butch’ or any other gay stereotype. He’s just a normal guy. And much happier than he ever was as a girl.
I’ve attended some support groups for relatives of transgendered kids, and heard that story over and over again. The kids whose parents denied them the right to change genders typically have terrible outcomes. They don’t ‘grow out of it’. Some of them leave home as soon as they can, often before they’re capable of really supporting themselves, and wind up on the streets or in the control of scumbags. Many commit suicide. This is not a problem to be trivialized with stereotypes about drag queens.
Gender identity is a complex thing. It’s not just a set of genitalia, it’s the net result of physiology, brain chemistry, and the way our neural networks develop. No one had to tell me I was male or that I should like girls - I just knew it. I’d know it even if I was blind and paralyzed and could not tell what my genitalia looked like. I can’t imagine the pain and anguish I’d feel if I had to look in the mirror every day and see a person I didn’t recognize and could not relate to, knowing that everyone else saw me that way as well.
For a transgendered person, being ‘misgendered’ isn’t just annoying - it’s like a knife through the heart, tearing apart your whole mental conception of who you are. The dysphoria is real, and it’s based on a real, physical mismatch between the gender of your brain and the gender of the rest of your body. It’s not a mental illness, a phase, a perversion, or just a desire to be different or to wear different clothing. You aren’t going to pray away the girl inside the boy, or fix them with a little Prozac and some counseling.
Unfortunately, in our culture gender is wrapped up in all kinds of issues of morality and religion and social construct, so problems like this are marginalized, trivialized, or denied. When people are born with obvious physical problems such as congenital heart defects or deformed limbs we have no problem intervening to fix them. But when the issue is a brain and body with mismatched genders, we want to believe it’s not real.
Sam Stone that was beautiful.
I love it! 
I’m a cisgendered woman that would fall into that 1/4. Although I am very definitely female and heterosexual, I’m also very “butch” in many ways from preferred dress to preferred hobbies to career choices. While I can wear heels and hose and makeup and all that it is very much a costume, not something that feels at all natural. Even when I wore woman appropriate formal office attire for years it never felt natural and unfortunately people often picked up that I found it uncomfortable. It was an act I adopted to earn money, nothing else, and one relief with my current job is that I will never be asked to wear such clothing again.
Now, my parents did feel it was very important that I could act in accordance with typical gender roles, and they even sent me to “charm school” to achieve this. Twice. It sort of took. I can, as I said, put on the costume and not be too embarrassing to myself and those around me.
It is very disconcerting for the people who have known me outside of formal-attire work to see me dressed up like that. They have often told me so, and on occasion failed to even recognize me.
There have also been occasions when people who have known me for years have, upon coming up behind me, addressed me as “sir” having mistaken me for a small man. This is not something I do intentionally, and it usually involves something like winter clothing, but the point is that despite being raised a girl and identifying as a girl I apparently sometimes have body language, a walk, and other “male” signals.
I don’t know - maybe some parts of my brain are “male” even if the gender identity part isn’t. Maybe I just picked up on the wrong signals growing up somehow (even if my family’s siblings were all women, and the extended family was woman majority). But if an unquestionably physically female person identifying solely as a woman can send out the “wrong” signals, then I’d think it highly likely that someone male in body being raised in a society that often punishes the “wrong” signals would wind up broadcasting male signals rather than female. If I, a ciswoman, had to consciously learn to “be a woman” (that is, act in a manner considered gender appropriate for some circumstances) despite an upbringing where the woman around me tried daily to get me to “act like a lady” then I don’t see it at all puzzling why a transwoman would need to learn to “act female” in those same contexts. At least when I acted sufficiently feminine I was rewarded for it - a transwoman as a child would all too often be punished for that exact same behavior.
Sorry that I was unclear. (Was typing as a “guest” and had a longer response lost twice.)
What I was trying to say is that there are very precise and somewhat objective guidelines for grading strength of evidence and of recommendations in medicine - the evidence as you summarized it in your post (accepting your review highly likely to be a fair and comprehensive one) at best would earn a “low quaity evidence” grade. Obviously randomized controlled prospective trials with adequate follow up numbers earn the best grades. Retrospective reviews can still give acceptable evidence but you do need to have some sort of treatment and non-treatment/alternative treatment arms to compare. My best guess grade is based not on the one review but on the summary you presented. I have not attempted, and will not attempt, a complete review of the studies myself. I appreciate the conflicting balance of making a decision without high quality evidence: the more aggressive a course is the higher the benefit needs to be and the the stronger the evidence must be; alternatively a great risk of harm associated with inaction can justify taking actions that have lesser evidence of efficacy but at least some reason to believe that there will be more benefit than harm. Clearly the risk of continued harm from the perception of externally being a gender discordant with how one percieves oneself is great. The converse on the evidence front is that the evidence of harm (other than those identified as defined surgical/anesthesia risks) seems virtually non-existant (agreed on your critique about the suicidality numbers) … so balancing that low risk of harm vs some, even if only a bit better than anecdotal, evidence of benefit, seems to be the nature of the informed consent conversation that I assume all have as part of the process.
If you are still participating in this thread I am hoping you can attempt again to explain what it meant and means to you to “feel female.” I ask from complete ignorance and recognize that this may be a bit akin to trying to get a good understand of “what does it feel like to be a bat?” What is the difference between feeling male and feeling female? I really do appreciate your post explaining that feeling of being drawn to the girl’s side as a peer group, that flocking feeling, but I am left still not getting it. Obviously I don’t have to, you know what it feels like … but how do you know that is what other females feel like? Can someone feel more comfortable and belonging with mostly female friends yet identify and be accepted as a male?
Do I need to accept that more of human gender roles/identity are primarily biologically based/innate (as opposed to being the result of cultural socialization/learned)? It seems like I must but I am very uncomfortable with where that path leads in areas other than transgender identity issues.
I agree. Well written, Sam.
Even without reading the studies (which, I’ve read some and found them convincing, but I was already biased in that direction ANYWAY, and it isn’t my field of study) to me it seems obvious there is something beyond genitals happening here.
I mean, let’s say the determinant is chromosomes.
XX=GIRL XY=BOY
But, what about XXY individuals? What about Turner syndrome? XXX syndrome? XYY syndrome? What about alllllllllllllllllllllllll those people who don’t fit into that binary?
Ok, so chromosomes don’t determine gender.
Let’s say genitals define gender.
Vulva/vagina=GIRL Penis=BOY
But, what about androgen insensitivity? What about inter sex people? What about alllllllllllllllllllllllll those people who don’t fit into that binary?
Ok, so genitals don’t determine gender.
Ok, fine. Let’s say people are the gender they feel they are. But, how do they know? Can we just take their word for it? How do we know they aren’t just crazy, or faking? What does it mean, to feel like a girl?
Well, we know in cases where a boy lost his penis in infancy and was raised as a girl, he still knew he was a boy. We know that most intersex babies grow up and have an idea of what gender they are. We know even when kids are raised without gender roles* they still form a sense of self that includes gender. We know that people have a strong sense of gender, despite whatever sexual orientation they have.
And we also have trans* people telling us THEY KNOW WHAT THEIR GENDER IS, and being beaten and teased does nothing to alter it.
It seems to me, if you look at it objectively, it’s very obvious gender is real, and that it’s something in the brain. Why or how that is, I don’t know. But I’m not going to deny someone the right to live the way they know in their heart they were meant to, just because Una can’t [perfectly explain how she knows she’s a woman. I don’t know how I know I’m a woman either. But, we are.
*to the extent this is possible
I won’t wade into issue about self-identification, choices in regard to societal gender norms, or choices in regard to surgery (my position on SRS is more libertarian now whereas in the past I felt it was a mutilation designed to accommodate a mental disorder–I still feel that but don’t see a real problem with it as long as the patient really wants the procedure and is of otherwise sound mind to make decisions), but on the brain issue which came up early (and with extreme incorrectness by Der Trihs) the last time I participated in a discussion on this issue around a year ago I said this and unless lots of research has happened in twelve months time nothing has changed:
Unless someone has substantial research (not just the endless derivative articles all based on the same two, small samples of brains of those two original studies) actually showing repeated and extensively verified evidence that people with GID have brains that are physically more like a typical brain of their perceived sex than their actual sex we’re still just tiptoeing around people’s feelings and ignoring the real science.
I’m not a wildlife biologist, but a biologist would typically say the sex of a mammal is determined at fertilization. For most mammals a trained biologist would be able to determine the sex based on a physical examination of the animal, but say the animal has deformed or malformed genitalia, the biologist could examine the animal’s genetics to see whether it was of the male or female sex. Once the biological sex is determined even structures more typical of the other sex should be rightly considered strange but essentially rare cases of physical development–up to and including the brain. It would take a fundamental altering of the understanding of mammalian sex to believe that a creature whose sex at fertilization was male actually had a brain that was biologically female. That’s a fantastical claim requiring very strong proof.
Chromosomes are pretty straightforward but the way bodies actually develop are extremely variable, that is why things in an individual sample may be wildly off the norm. You may find structures that are more typical of the other biological sex, but that isn’t in and of itself sufficient to alter our view on the biological sex of the animal. (This would again, be restricted to mammals as many non-mammalian animals do not have chromosomal determined sex.)
In mammals the overwhelming and settled biology is that sex is determined at fertilization based on the chromosomes. In mammals any animal with two of the possible sex chromosomes is male, an animal with only one is female. So any mixture of X and Y = male, and any arrangement of solely X is female.
Turner’s syndrome (at least sometimes) and other such things are an example of mosaicism. In that case a single organism has multiple genotypes because of errors in cell division. In those cases there is no clear answer as to what biological sex the overall organism is–but I’ll note that based on all the evidence I’ve seen the typical GID patient does not have any form of mosaicism.
Gender is a word that originally had an exclusively grammatical meaning and later came to have the meaning associated with social conceptions of how the “typical human in society of one of the biological sexes should act, behave and etc.” Since that is a behavioral thing, it does not have to be the same as the biological sex, especially when those behaviors are typically cultural. But if your gender is out of sync with your biological sex I’d say you have a problem–but that doesn’t mean your biological sex isn’t your biological sex.
Ok then. The thread title says “gender identity,” and that’s the word a lot of us have been using throughout this discussion. You might be able to say sex is biological, but gender is more complex. It has biological and cultural components and perhaps other elements I’m just not thinking of. So talking about sex and glossing right over that issue doesn’t tell us much of anything.
I agree, they are separate issues and if I was saying only one of the issues was worthy or important of discussion you might have a point. What I was specifically doing was challenging anti-factual assertions. Der Trihs for example made a biological claim that you can identify the brain of an individual with GID “by sight” because it is fundamentally different from that of a healthy brain. That’s making more than just a gender identification claim, that is making claims about physical biology that isn’t supported by the two studies I know of where researchers actually cut into the brains of deceased transsexuals. In those studies the differences were in size and neuron count of a small portion of a portion of the brain, and would not be noted by a visual examination of the brain. In fact given all the variation in sizes of the different portions of the brain the size differentials in question only through comparative analysis of several subjects could the researchers even make any conclusions at all.
There were several other factually incorrect statements, like the assertion that it is settled science in general that persons with GID “have the brains of someone of the opposite biological sex.” We’ve actually discovered minor abnormalities, in a very, very small sample size of brains (not many of these studies have been done, ever compared to the number of studies on many other subjects of brain science for example) that deals with a small portion of the total brain itself. There is not much settled science on the causes or unique brain abnormalities for a mental disorder that is far more common than GID–schizophrenia, and it has been researched far more and there are far more patients and patient cadavers to study and far more money has been poured into studying it. Even homosexuality, something that is researched heavily we have no consensus understanding of how it occurs or etc. So these strange and leaping conclusions people want to make when it comes to asserting things about the brains of persons with GID or other things relating to people with GID is strange to me, given how reserved people would be to jump to such absolutist statements when dealing with anything that didn’t involve LGBT issues–but just because something touches on a political area like that doesn’t mean the science instantly becomes settled.
miss elizabeth my post in no why implies denying anyone anything. And if it is something that cannot be articulated other than that sense of “belonging with” then I will have to accept that. I readily accept that there is a brain difference that predisposes to a self-perception of being a gender other than external appearance and biological sex is consistent with. I accept that such causes severe dysphoria and can cause a host of secondary psychiatric issues both from that sense of mismatch and even more from the reaction others around the person to that sense of mismatch, both family and peers. Rejection, beatings, telling them they are wrong or “crazy”, is a cause of serious harm. It is not the same as some more common exploration of gender roles (boys trying on make-up or dressing on mother’s clothes and girls pretending to shave like Daddy) which are common phases; those are kids who “know” what gender they are.
Whether or not it gets labelled an illness may be semantic. There is a mismatch of how the brain directs self-perception of gender identity and what biological identity otherwise is that often causes much pain. If it did not cause pain and dysfunction then I would label it a difference not a disorder. But it does cause pain so it is a disorder or illness. The subject of how to best proceed to best help with that dysphoria seems well covered by now, to the degree it can be answered with the information available. If I understand correctly expert opinion, based on some evidence of debatable quality, is a phased approach, trying to do the least aggressive first and progressing if needed to more agressive measures, and dealing with any comrbidity along the way. Thus begin with acceptance and acknowledgement that what they feel is real and move into psychotherapy and farther into hormonal therapy and from there to SRS with the individuals fully informed of the possible risks and benefits along the way. I have concluded that approach is very sound whether one believes the evidence is strong or weak or whether one thinks of the condition as an illness or as a difference that causes pain.
I am trying to understand in my head better what it feels like and to better tease out what I think are gender roles vs gender identity, perceptions of what we think others feel like (either of our same physical gender or of the other one), how accurate those perceptions are or are not and how we conclude that. I do not know, I know I do not know, and when I do not know I ask those who likely know more than I do for answers.