Some of the discussion that's been going on in the topic
Would the SOC be any better if run by post-op trans-people ? has got me thinking about the terms used in the SoC/WPATH, and wanting to explore some of this more. I know, I know - it's not like we don't already have umpty-billion topics in which the terminology-wars are continually waged, but I think I may be coming at this from a different angle, so I'm going to have a go at putting my thoughts on "paper" and see what people make of this (and I'm hoping this will clear things up for me too).
I don't want this to become in any way a this-person-vs-that-person topic. I'm just going to try to say what I think, and assume others will think differently (that's pretty much a given!) Anyway, here goes.
For me, this stems particularly from a discussion about whether "transsexuality" is a condition that has a cure, and whether dysphoria is a condition. I think there's something off-beam about how the terms are used in the official definition - including specifically how the term "dysphoria" itself is applied. By off-beam, I mean inconsistent and inappropriate.
In the US, at least, someone described as transsexual by the SoC is specifically someone who wishes to change their anatomical sex characteristics to match their experience of their sex - which is different from the sex they currently anatomically present as (or something like that - I'm not quoting, I'm just summing up what I've read). So let's go with that rough definition for the moment, and perhaps include the broader transgender aspect later on. The healthcare system has decided for the moment to call this (and other experiences) "gender dysphoria", and to label this as a condition. This is partly to move on from calling it a "disorder", but also presumably so that there is still a way to include it in their clinical framework and provide healthcare and support for people whom this fits (and to decide whom it does fit, and who has other issues that just look similar to this).
The problem for me is one of perceptions. As I see it, being transsexual (as defined above) isn't a "condition", it's simply a fact of some people's lives (our culture, being so obsessed with sexual and gender "norms", has yet to catch up with what a lot of more "primitive" cultures hve always been hip to). They have a body that is one sex anatomically, but they experience themselves as being the other sex. This is not in itself a condition (let alone a medical or mental health condition), it's just an experience.
And I don't think "dysphoria" is a condition either. Dysphoria literally means "finding it hard to bear", and implies very simply and directly that something about your current state makes you unhappy in a way that is not easy to live with. So effectively, and for the convenience of having a label to support/treat people under, the healthcare system is forced to call this unhappiness a condition. But to me, dysphoria in this context is not a condition, it's a response to an experience (that's being called a condition!) - that of being in a body that doesn't fit one's sense of sex. For some people, this unhappiness is genuinely debilitating, and can only be addressed by changing their anatomy. And evidence indicates that it's a very individual thing, at what point along the line of possible changes an individual finds themselves no longer unhappy, or finds themselves happy enough to stay put where they are on that line.
In the broader context of transgender, I guess you could say it's a response of unhappiness at not being able to present in the way that one feels fits one's experience of gender - which may or may not include discomfort with one's anatomical sexual characteristics, or it may be more subtle than or different from that, it may be in the cultural rather than the anatomical arena (i.e. how one presents in terms of behaviour and clothing and appearance, and feels able to express one's natural self in that way) or it may cover all of that at once. And the trigger for the dysphoric element is just as often the cultural pressure not to simply be oneself. If we could just get on with it, there'd be no tension.
At this point I want to remind myself (and anyone who's got this far!) that I'm not trying to make definitive definitions of terms, I'm saying what they mean to me, and what they appear to mean to the healthcare system. Bear with me, I know this is all a bit clumsy.
Personally, I would come under the US-stylie definition of "transsexual" because I wish to change my anatomical characteristics to be as in line as possible with the sex I experience myself as - I have a male body, and I want it to be female, and it's mostly the genitalia that I'm concerned about. but I don't think "gender dysphoria" describes my experience at all well. for a start, I think that phrase is a misnomer in any case because when the terminology is trying to make a distinction between sex and gender, it's counter-intuitive to call this experience gender dysphoria, when it should be called something more like "sex dysphoria". But better yet, it should be called something like "sex dislocation". Whuffo? Well in my case at least, I certainly don't have "gender dysphoria". I'm very happy with my gender, at last - it's just that my anatomy doesn't match it, and never fully can. I was very unhappy about that for decades while I thought I couldn't do anything to address it, but I no longer feel that.
This is where it gets potentially contentious. I don't see my transsexuality as being something curable, I see it as a disability. It's a disability that I can manage, and that can to some extent be addressed with surgery and pharmaceuticals. A "cure" for me would be waking up one day in an actual female body, having lived my life in it as a female. Since that's out (until I get reborn
), I'm content to be aiming to have a body that much more closely resembles that, and I'll just have to deal with the rest of it as best I can, emotionally. And I'm confident that I can do this.
But I don't feel that I'm being treated for dysphoria - I'm being treated to overcome a disability to which I have dysphoric responses from time to time. This is familiar territory for me, as I've been missing some muscles since birth, and I've gone from feeling distressed, angry and sickened by this as a teen, to being completely at ease with it now (well, it does stop me from playing b->-bleeped-<-ipes, but that's the only unfulfilled longing that it's the direct cause of
).
So long as the healthcare system regards transsexuality/transgender experience as a psychological/emotional phenomenon, rather than as a straightforward state of being, it's inevitable that it will be labelled and responded to inappropriately, to some degree. And I'm resigned to having to put up with fielding the healthcare system's assumptions about what's going on for me and how to respond to it. But I don't have to agree with it.
Phew. Having written all this, I'm really not sure if any of it is relevant to anyone but me - but it's done me some good getting it out there.
So enough about me. I'm interested to know what dysphoria means to others, or whether you have any responses to what I've written about my experience and perceptions. (and of course,
TL;DR is an acceptable response
.)
