How is a biological male feeling female different from me feeling like Napoleon?

[Marley23]

@Mosier

Why shouldn’t we treat transgenders with psychological therapy instead of surgery and hormones?

I think a lot of these people are in therapy, probably for the long term. Psychological evaluations are required before a person is able to have the surgery and hormones.

@Koxinga

I predict much scoffing and exaggeratedly sad shaking of heads in this thread, followed by little or no answer to the question.

ETA: though I didn’t see horsetech’s link just now – that’s informative.

If there’s scoffing (which there shouldn’t be, but that’s life), it’s because this is something of a settled issue on the SDMB. It used to be pretty controversial but because there have been some TG posters here over the years who explained themselves and what they’ve been through, there’s something of a consensus these days.

@Koxinga

Sure we do. For left handed versus right handed, a severe schoolmarm with a fast ruler across the knuckles is all it took for my grandfather.

This doesn’t work for everybody, and I think most people now realize this is kind of a dumb thing to do to a child. Your grandfather’s teacher was able to teach him to write with his non-dominant hand using violence, but he still had the mental wiring of someone who is left handed. The person can be trained to do something that’s not in accord with it, but handedness is determined by the brain. Lefties and righties have some differences in the makeup of their brains, and that’s not changeable.

By the same token, even if you could “train” someone who feels TG to feel like their biological gender (and I’m not sure you can), I’m not sure that would produce the outcome where the person is happy and reasonably well adjusted. That’s a priority for most people.

from society’s standpoint, the required behaviors & roles have been successfully applied.

The standard appears to leave these individuals miserable. That’s kind of a problem for society because they don’t contribute as much if they kill themselves.

But it’s a social and political question as to whether society should respect the rights of the individual in these particular cases.

I guess it is. But the original question here was if there is some kind of biological basis for this condition, as opposed to ‘it’s just in their minds’ (with the implication being that these people are delusional). And the answer is that there is. On that basis there’s a pretty good argument that society should respect their rights.

@I_Love_Me_Vol.I

But what if you know that you are Napoleon? Trapped in a non-Napoleon’s body? What shall society do then? What shall YOU (the individual who knows that they are Napoleon) do?

See above. If you can prove the person has the mental makeup of Napoleon, you’d have an argument they should be treated like Napoleon. That not being the case, someone who thinks he is Napoleon is having a delusion.

@Koxinga

And to address the OP’s point more directly, take (1) a schizophrenic hearing voices and (2) a pre-op transgendered person. From a certain standpoint, couldn’t you say that (probably for reasons of brain chemistry) each person’s mind is telling him something that is at divergence with reality? Patient #1 is hearing voices that demonstrably are not there, and Patient #2 is convinced he ought to be a woman when he is demonstrably a man.

The word “ought” makes all the difference there. Someone who hears voices that don’t exist is having a delusion. A woman who believes she’s physically male is having a delusion. A person who thinks he ought to be the opposite gender has a different condition.

[Koxinga]

@Marley23

The word “ought” makes all the difference there. Someone who hears voices that don’t exist is having a delusion. A woman who believes she’s physically male is having a delusion. A person who thinks he ought to be the opposite gender has a different condition.

Fair enough . . . to a point, I think. Let me clarify once more, though, that I’m not disputing that transgendered people exist or they ought to have the current treatment they do: I think the OP touches on the question of why they’re treated differently and (I still believe) it’s an essentially sociological question, which is why I took the line of argument I did.

Bowing out for now – Koxinga

[Shodan]

I think we ought to treat transgendered people the way Der Trihs treats theists. Both are suffering from delusions, right?

Regards,
Shodan

[Marley23]

I know that’s an analogy, but let’s not turn this into a theism vs. atheism debate.

[Skald_the_Rhymer]

@Der_Trihs

Because psychological therapy doesn’t work.

DT, do you mean that psychological therapy does not work in general, or that it does not work for transgendered persons?

[Alessan]

I’d say a transgendered man who believes himself to be a *specific *women requires treatment, just like a man who thinks he’s a *specific * 19th-Century Frenchman. However, society is full of people who believe that they’re Napoleon *in general terms *- meaning that they think that they’re superior beings who must be obeyed by all. I’ve met plenty of these people, often in the fields of education and law enforcement; they’re annoying, but perfectly sane.

[Der_Trihs]

@Skald_the_Rhymer

DT, do you mean that psychological therapy does not work in general, or that it does not work for transgendered persons?

The latter; or rather, it doesn’t work to convince them to be happy as the gender they are “supposed” to be.

[Bridget_Burke]

@Magiver

I think the question is then why don’t we treat the brain and not the body. If it’s a physical characteristic that can be identified then treat it with hormones or some other therapy rather than hack up the body into something that is less functional than it originally was.

Yes, the body becomes “less functional” after surgery–if you think our only purpose on this planet is reproduction. (Last time I checked, the human race was in no danger of extinction.)

Without treatment, the “patient” might be able to marry & go through the motions often enough to produce children. Too bad for the spouse, who will always feel that something is not right. (Based on my very early experience with a guy who was trying to prove he wasn’t really gay. Unsatisfactory for me. Eventually he came to terms with his own reality & did much better.) Too bad for the kids, being brought up in a home with too many secrets.

People who’ve studied the human mind became convinced that sexual reassignment can be a useful therapy; the opinion wasn’t reached overnight. I’m pretty sure there’s plenty of analysis beforehand in each particular case.

Why does this bother you, personally?

[kanicbird]

IMHO we are all ‘pieces’ of one spirit, that given by God. In our lives this spirit in us connects and splits with others many times, especially when our hearts are open, which is infancy and later in life when in a relationship, and we take on other aspects of the people we open out heart to. This system is often unintentionally abused, especially against small children who have open hearts, but again later in relationships where one person dominates the other, it becomes very easy for people to take parts of their spirit and leave behind other parts.

In the case of transgendered, it very well may be the effect of feminism, women wanting more traits of men, which they acquire from men and male children, swapping them for feminine aspects of their spirit. Transgendering would be a outplay of this and the male would feel female as their male spirit was taken (usually bit by bit) and he was given a female spirit in exchange. That female spirit longs for a female body, which sometimes drives the person to make themselves appear like the opposite gender, but is ultimately unfulfilling.

In the case of Napoleon, that spirit is there somewhere if it did not return to God, so it can get into someone.

[Marley23]

@kanicbird

In the case of transgendered, it very well may be the effect of feminism, women wanting more traits of men, which they acquire from men and male children, swapping them for feminine aspects of their spirit.

Again, this is not a debate on religion or spirituality, or, for that matter, feminism., so take this stuff to a thread on one of those topics or start a new one.

[Revenant_Threshold]

@Magiver

I think the question is then why don’t we treat the brain and not the body. If it’s a physical characteristic that can be identified then treat it with hormones or some other therapy rather than hack up the body into something that is less functional than it originally was.

Because, generally, when we consider what makes up a person the mind and brain are tended to be considered to be the seat of the self, and the most important part. Lose a part of your body, and you’re considered the same person, but with a bit missing. Lose a part of your brain, or your mind, and you may well not be considered the same person at all. In general, it doesn’t seem all that unreasonable to say that so far as priorities go, the brain and mind should take priority over the body, so far as altering bits goes.

Now, of course, there is a problem. We know that the brain can go wrong. If (to go with the OP’s example) a person believes they are Napoleon, while actually being Bob from Newcastle, they likely enough are suffering from delusions. Because we generally consider the brain to take priority, should we adjust Bob’s body to match him to Napoleon’s characteristics? I would say no, for two reasons; first, that we are comparing Bob’s brain to a normal brain, and seeing that there are, presumably, differences. Too, Bob’s brain is likely different from Napoleon’s brain, though unfortunetly we can’t check that one. And secondly, Bob’s delusions are extensive; he literally does not have Napoleon’s brain, or Napoleon’s body.

Compare to a transgendered person. We can compare their brain to normal brains of their supposed gender, and they won’t match; but they will be similar to those of the opposite gender, as indeed they claim. Too, if this is the case, there aren’t, actually, any delusions. They are correct in saying they have the brain of the opposite sex - they do. They, unlike Bob, do not believe their body matches their preferred sex; to the contrary, they are usually all too aware that their mind and their body do not match.

And that would seem to be the difference, so far I can tell; the brain of a transgendered person is working perfectly; it’s just in the wrong body. Treating with hormones or some other therapy to try and change it into a brain of the opposite sex isn’t a matter of fixing something broken, it’s a matter of trying to break something that works into something that’s broken in just the right way to seem normal. It’s not like fixing a broken arm, it’s like breaking a leg and trying to mold it into a new arm.

As for the lack of functionality; we elect to lose functionality from ourselves all the time. Us all not being fitness-mad, we have lost functionality of our bodies pretty comprehensively without the need for surgery. People often choose to have their ability to have children changed.

[John_Mace]

@Mosier

The title explains it all. I don’t understand why one is a psychological disorder and the other isn’t. Why shouldn’t we treat transgenders with psychological therapy instead of surgery and hormones?

What is a “biological” male? Please don’t say XY chromosome, because we know that isn’t all there is. I think the answer to your question lies in making sure you know the right question(s) to ask.

[Der_Trihs]

@John_Mace

What is a “biological” male?

A male non-robot?

[Skald_the_Rhymer]

@Der_Trihs

A male non-robot?

I am offended by your anti-robotism. Next you’ll be saying that Data is not a person.

[Mr.Excellent]

@Der_Trihs

Because barring time travel, you can’t possibly be right. And because pandering to people who think they are Napoleon makes them worse, while helping people who feel like they are in the wrong-gendered body be more like they imagine they should be makes them better.

Because psychological therapy doesn’t work.

We don’t have hormones or any other therapy that can change the brain like that, any more than we can make gays straight, left handed into right handed, or chemically induce a love for black leather and discipline. Our ability to modify the brain is very, very limited; much worse than what we can do to the body, and much riskier as well.

There’s also the ethical position that mind trumps body, which I hold.

I don’t agree with everything in the above quote, but I think the core point is spot-on - if surgery yields the best result, in terms of the patient’s ability to function and quality of life afterwards, then it’s the appropriate therapy. And it’s a therapy we can provide. Sadly, we can’t give the fellow who thinks he’s Napoleon an empire.

[Triskadecamus]

You know, real transgendered folks would not ask this question. They are already quite familiar with the extended process of psychological therapy, and psychoactive pharmacology that happen before you ever get sexual identity reassignment from a reputable medical source.

But, the meme of irresponsible queers having surgery for kicks is so much easier to argue against.

Tris

[tumbleddown]

Pro tip: trangender is an adjective. It is not a verb. It is not a noun. The -ed and -s endings? Not correct.

Carry on.

[Bricker]

@Mr.Excellent

I don’t agree with everything in the above quote, but I think the core point is spot-on - if surgery yields the best result, in terms of the patient’s ability to function and quality of life afterwards, then it’s the appropriate therapy. And it’s a therapy we can provide. Sadly, we can’t give the fellow who thinks he’s Napoleon an empire.

This is the right model, I think. Even if we were to concede that pre-op transgender folks are suffering from some massive delusion, it’s clearly not a delusion that’s amenable to therapy. Reassignment surgery can permit them to live a happier life, and be, post-op, a relatively unremarkable member of society.

What factors weigh against sexual reassignment surgery? How is liposuction or breast augmentation surgery acceptable? (Assuming the OP thinks they are.)

[Jimmy_Chitwood]

@Koxinga

I predict much scoffing and exaggeratedly sad shaking of heads in this thread, followed by little or no answer to the question.

ETA: though I didn’t see horsetech’s link just now – that’s informative.

Well isn’t that ironic.

For my part, I’m not sure I understand how it benefits either party - society or the gender dysphoric person - to deny that there’s something going on when, one, sure, there’s medical evidence to suggest it’s real, but two, if it isn’t real, there are a lot of people who just happen to be making this stuff up at great expense and incredible pain to themselves, and whose either delusions or deliberate fraud sometimes seems to coincide exactly with them receiving the medical attention they’re claiming to require.

It seems to me, based on my own personal experience with the subject, that the only driving motivation to deny that this is a real phenomenon is just personal distaste or disbelief. What’s in it for society at large for us to mock these people, marginalize them, compare them to people with hallucinations, and deny them the identity that they – cogently, consistently and reasonably – lay claim to? Personally and selfishly we can benefit by calling them weirdos and not having to deal with the issue any further, but beyond that I don’t see what’s in it for society.

On the other hand, since as a few others have said above, there is something society can do that at least takes steps toward improving these people’s lives, well, what’s the problem? Where’s the profit in ignoring what they actually say about their difficulties and talking about Napoleon?

[CalMeacham]

But what if you know that you are Napoleon? Trapped in a non-Napoleon’s body? What shall society do then? What shall YOU (the individual who knows that they are Napoleon) do?

I’m a militarily brilliant benevolent dictator born into the body of a schnook.