Why all the anger at me for knowing what I need?

[suzifrommd]

I was just treated to a multi-page, profanity laced, diatribe on the local transgender facebook group. I posted on my local transgender facebook group about being evaluated for my second surgery letter (my GT already sent my first), where I said that I didn't want a doctor substituting his judgment based on an hour or two with me for mine based on more than a year of soul-searching.

I was treated to an insulting, multi-page profanity-laced diatribe from one of the post-op women.

She went on and on about how the fact that I didn't care what the doctor said meant that I was rushing into surgery and probably wasn't emotionally ready for it. (That's a MUCH more polite distillation of pages of complete vitriol).

This isn't the first time this has happened. The doctor I saw for my second letter, had a similar reaction – almost a disdain for my judgment. Before him, a psychiatrist that had evaluated me before I went into therapy made it much more plain that he had contempt for my ability to tell what was good for me and even more for my opinion that I knew better than he did.

Where is this anger coming from?

Why does it make so many people so mad when a trans woman thinks she knows what she needs?

[Nero]

Probably two places - personal experiences and sexism. They had to jump through hoops, so you should too and that women are never seen as competent authorities on their own experience (and these women have bought that).

[ThePhoenix]

Probably two places - personal experiences and sexism. They had to jump through hoops, so you should too and that women are never seen as competent authorities on their own experience (and these women have bought that).

This.

Plus, it's not PC to say this, but there is a lot of serious mental illness in the trans* community.  Some degree of screening probably does make sense due to that.  But some carry the idea that it is needed a little too far. 

And then, of course, there are the transphobic folks.  I did not know there was a local transgender Facebook group, but I do know some of the local LGBT groups just reek of transphobia. 

[Shantel]

This isn't the first time this has happened. The doctor I saw for my second letter, had a similar reaction – almost a disdain for my judgment. Before him, a psychiatrist that had evaluated me before I went into therapy made it much more plain that he had contempt for my ability to tell what was good for me and even more for my opinion that I knew better than he did.

This is the very reason I did an end run around the entire process, I have a BS detector, know when I'm being jerked around and a very short fuze!

[Hikari]

I have encountered people like that before too, but being as I am not quite as far along in the process it was a rather scathing response to me going on hormones without the SOC recommended of 3 months of therapy/RLE. The way I see it, people many time view doctors and even therapists as almost infallible but, I know very well that they are. I also know myself.

I am not sure if I will be able to avoid all of the "process" like Shantel, but I will if I can. I am me, I know me, my choices are my own, and I know what I want, I have known for some time. I won't have permission to live my own life.

I am finding that there is only a small minority of the medical community that thinks your knowledge or even your needs matter at all. Like, you have to convince them what you want was their idea or they will reject it outright, and that honestly just makes me very mad. I have experienced less of that from transgender people online, but I have not only in avoiding the SOC but also in doing things in the order I do. Apparently there is some list out there and if you don't do things exactly in the order that they expect the sky will fall.

[Sephirah]

Some people just like to be condescending and act like they know it all. It makes them feel better about themselves.

That isn't just limited to trans issues.

It says more about them than it does about you.

[Ms Grace]

Some people are just wildly immature jerks and have no idea how to express themselves without being unpleasant. I think you should exercise the Report and Ignore functions of FB!

[Adam (birkin)]

I think what Phoenix said is true. There's a lot of mental illness amongst trans people, and there are a lot of mentally ill people who think transition is the answer. I can see why some people are resistant to the idea of someone being able to get it quickly - there could be regrets down the road (not for you necessarily, just in general).

That said, I think what FA said is true as well. Some people think "I had to struggle for it, so should you, why should you get it easier than me?"

[KelsieJ]

I think what Phoenix said is true. There's a lot of mental illness amongst trans people, and there are a lot of mentally ill people who think transition is the answer.

Sorry, but I have to take issue here with what you just said, so I hope that you take it in the spirit in which it's meant and not as an attack for saying it.

There is a high incidence of depression among transgender people. Most of it is caused by the pressure to conform, needing and wanting to "pass", to "fit in", to be "accepted" and to be seen as "normal". There is also a large proportion who feel that surgery will correct all of that for them, when surgery is merely a part of the process for people who choose it. The HRT portion of transition is the most important part, but comes with a price tag - and that is that it can cause depression to worsen on occasion. It can also lift depression in some people. The key to transition is not to single out someone with a psychiatric condition in the trans* community, but to understand that a large portion of what you may be observing, is merely situational and due TO their transition and unrealistic expectations of what transition means. This is why I always recommend that anyone considering a transition works with a therapist, even if they do not appear to have any depression or other psychiatric condition.

Kelsie

[JesseG]

Hi Suzy,
I'll be more general - it sounds like "teh internet" happened to you. I don't see this as a trans-specific issue. Take a topic, any topic, and there are some people online willing to 'do battle' over it. You have to weed out a lot of crazy to get to the few nice people on the web. You just drew the short straw.

As for her leaving pages upon pages of vitriol for you:
"The definition of a zealot is someone who won't change their mind and won't change the subject."

Cheers,
- Jesse

[Missadventure]

This isn't the first time this has happened. The doctor I saw for my second letter, had a similar reaction – almost a disdain for my judgment. Before him, a psychiatrist that had evaluated me before I went into therapy made it much more plain that he had contempt for my ability to tell what was good for me and even more for my opinion that I knew better than he did.

I've seen this in the medical community in general. The "my educated opinion is more valid than your experience" syndrome. About three years ago I had to have my gallbladder removed. It was packed full of stones, and one of them eventually ended up blocking the common bile duct.

I'd been battling the EXCRUCIATING pain of passing stones for 6 months. I knew what it was based upon an hour of research on the internet, but, in 16 trips to the ER and 4 trips to my GP I was never able to convince anyone it was my gallbladder. I kept being told I just had really bad heartburn, and that I was too young and the wrong gender for it to be my gallbladder. That probably would've kept going on forever, had I not noticed gallstones in my poop one day after a particularly agonizing attack, and I went so far as to fish that out and bring it in to the doctor. Thats when they finally decided to do bloodwork and an ultrasound, and low and behold my liver function markers were all out of whack, my gallbladder was PACKED with stones, and I had a stone blocking the CBD.

So, it has nothing to do with being trans, and everything to do with some people being completely and totally self absorbed with their own sense of self importance.

[ThePhoenix]

Sorry, but I have to take issue here with what you just said, so I hope that you take it in the spirit in which it's meant and not as an attack for saying it.

I for one am not at all offended, and I appreciate your chiming in with a contrary view.  Although I'm not sure we disagree all that much really.

There is a high incidence of depression among transgender people. Most of it is caused by the pressure to conform, needing and wanting to "pass", to "fit in", to be "accepted" and to be seen as "normal". There is also a large proportion who feel that surgery will correct all of that for them, when surgery is merely a part of the process for people who choose it. The HRT portion of transition is the most important part, but comes with a price tag - and that is that it can cause depression to worsen on occasion. It can also lift depression in some people. The key to transition is not to single out someone with a psychiatric condition in the trans* community, but to understand that a large portion of what you may be observing, is merely situational and due TO their transition and unrealistic expectations of what transition means. This is why I always recommend that anyone considering a transition works with a therapist, even if they do not appear to have any depression or other psychiatric condition.

Kelsie

Well, two things.  First of all, not everyone is the same.  So HRT for some people is the most important thing.  For others it isn't.  Different strokes for different folks.

Second, I both agree and disagree about the mental/emotional issues.  At this point I've seen and met and talked with hundreds, if not thousands, of trans* people.  With so many you do start to notice some things.  I agree that there is a lot of depression (and anxiety) in trans* people.  It can be caused by experiences related to transitioning or by unrealistic expectations (very common!) about transition.  It can also be related to the dysphoria pre-transition.  In either case it may clear up at some point during or after transition.  It's also interesting to see the surprising ways people just seem to get more functional when they transition at times.

But I also encounter a lot of things in trans* people that I see a lot less of in the general public.  Autism is a big one.  OCD is another.  Then I talk with counselors and doctors who tell me about high prevalence of disassociative personality disorder and other personality disorders in trans* populations.  They also confirm things lie the correlation with autism.  Now, of course correlation is not causation and I am emphatically NOT saying that being trans* makes people mentally ill.  But I do believe we are a population that has many of those things going on at a higher rate than the general public.  And it makes sense to me to have some safeguards built in to make sure that such a population is going in for major surgery with eyes wide open, having thought it through and understood it, and not because of some sort of mental illness. 

[Cindy]

I think this is a mixture of circumstances that have been put forward already.
Firstly some people, and I will include myself, needed a bit of help from a therapist, mainly to go through my life and sort some stuff out, secondly to make sure I understood my options and what was going to happen to me and thirdly to have someone to sort through any issues that may crop up. I was ready to go after three sessions, by a local law I have to keep in touch with my therapist every 3 months or so to make sure I'm OK, that is a 10 min appointment.

I'm fine, no issues and happy, some other women I know have needed prolonged interaction with their therapist to sort through issues and were not ready as quickly as I and in some cases are still not ready to 'take the leap'.

They can get a bit jealous of people like me who don't have any problems. Sadly human jealousy manifests in many ways, sometimes by the sort of rubbish that Suzi has been subjected to. In my case I ignore it, feel bad that someone hates me so much and rise above it with a smile, glad that I am OK.

It happens in all walks of life, people get jealous of others good fortune be it winning some money, getting a good job, having some good luck.

As for professionals in the field who express such silly opinions I would neither consider them professional nor people who should be working in the area as they are demonstrably too ignorant to perform their duty to their clients.

These are small people who live small lives. I just feel sorry for them and move on.

[Jill F]

These are small people who live small lives. I just feel sorry for them and move on.

^This^  Nice one, Cindy.  On a side note, this is why I don't waste any hatred upon people that should simply be pitied.

[ThePhoenix]

As for professionals in the field who express such silly opinions I would neither consider them professional nor people who should be working in the area as they are demonstrably too ignorant to perform their duty to their clients.

These are small people who live small lives. I just feel sorry for them and move on.

Ironically, a study on the prevalence of four different mental disorders in children and teenagers was just published a couple of days ago.  Here's the punch line: "Compared to the control group, gender variance was found to be 7.59 times more common in participants with [autism spectrum disorder]. It was also found 6.64 times more often in participants with ADHD."  Here's a link to a summary.  The link to the published research appears at the bottom of the page linked to:

http://www.sciencedaily.com/releases/2014/03/140312103102.htm

I understand that trans* people would not want to believe that mental/neurological problems are correlated with trans* status.  I too get more than a little sick of hearing that we are all defective people.  I am fond of saying that trans* people are not born defective, but we are born spicy.  As in the spice of life. 

But at the same time, all medical/scientific evidence I know of seems to indicate that certain mental issues are more common in trans* spectrum individuals, although not saying that they cause trabs* status or are caused by trans* status.  If you have any evidence to the contrary! please do bring it forward so that we all may be better informed.  Otherwise I can only say that we are probably best served by grappling with unpleasant realities like this.

[Cindy]

Ironically, a study on the prevalence of four different mental disorders in children and teenagers was just published a couple of days ago.  Here's the punch line: "Compared to the control group, gender variance was found to be 7.59 times more common in participants with [autism spectrum disorder]. It was also found 6.64 times more often in participants with ADHD."  Here's a link to a summary.  The link to the published research appears at the bottom of the page linked to:

http://www.sciencedaily.com/releases/2014/03/140312103102.htm

I understand that trans* people would not want to believe that mental/neurological problems are correlated with trans* status.  I too get more than a little sick of hearing that we are all defective people.  I am fond of saying that trans* people are not born defective, but we are born spicy.  As in the spice of life. 

But at the same time, all medical/scientific evidence I know of seems to indicate that certain mental issues are more common in trans* spectrum individuals, although not saying that they cause trabs* status or are caused by trans* status.  If you have any evidence to the contrary! please do bring it forward so that we all may be better informed.  Otherwise I can only say that we are probably best served by grappling with unpleasant realities like this.

I am in no way denying that many people with gender incongruence suffer from comorbidities, that is well recognised and clearly understood by professionals in the area. What I argue is professionals who have inadequate training and fail to understand the clinical nature of their clients are failing their clients and failing their fellow professionals by misrepresenting the help and care that is both needed and required.
If I understand Suzi's comments in the OP correctly, she was rejected by professionals who should not have done so. They suggested to her opinion that was incorrect in her case. That is a failure in care.

In the clinic I am involved with we have about 60% of clients who need little more than a case history study, a proper analysis of the clients situation and referral to the medical team to deal for hormonal and surgical reassignment as required by the individual according to their desire and need. The 40% who require further psychiatric therapy need that as ongoing treatment, the timeline of which varies according to the client's requirements. Most of that 40% do have satisfactory outcomes eventually, either in achieving a reassignment but more importantly for some to achieve living happily without reassignment.

It is important to be able to distinguish the cohorts at a clinical level. Professionals who are inadequately trained to do so cause inordinate grief to both groups.

[ThePhoenix]

I am in no way denying that many people with gender incongruence suffer from comorbidities, that is well recognised and clearly understood by professionals in the area. What I argue is professionals who have inadequate training and fail to understand the clinical nature of their clients are failing their clients and failing their fellow professionals by misrepresenting the help and care that is both needed and required.
If I understand Suzi's comments in the OP correctly, she was rejected by professionals who should not have done so. They suggested to her opinion that was incorrect in her case. That is a failure in care.

In the clinic I am involved with we have about 60% of clients who need little more than a case history study, a proper analysis of the clients situation and referral to the medical team to deal for hormonal and surgical reassignment as required by the individual according to their desire and need. The 40% who require further psychiatric therapy need that as ongoing treatment, the timeline of which varies according to the client's requirements. Most of that 40% do have satisfactory outcomes eventually, either in achieving a reassignment but more importantly for some to achieve living happily without reassignment.

It is important to be able to distinguish the cohorts at a clinical level. Professionals who are inadequately trained to do so cause inordinate grief to both groups.

Ahhhhh, I think I understand now.  I misunderstood originally.  My apologies.  I thought you were responding to birkin and me about the existence of those comorbid conditions.

[Hikari]

Ironically, a study on the prevalence of four different mental disorders in children and teenagers was just published a couple of days ago.  Here's the punch line: "Compared to the control group, gender variance was found to be 7.59 times more common in participants with [autism spectrum disorder]. It was also found 6.64 times more often in participants with ADHD."  Here's a link to a summary.  The link to the published research appears at the bottom of the page linked to:

I don't really understand what you are getting at. None of those things mean that the transperson doesn't understand what they want, or should have to jump through additional hoops, or justify the medical community brushing off their concerns because they think they know what is better for the patient than the patient does.

Regardless, I don't have any of those conditions, and I certainly shouldn't be treated as if I do. Particularity any depression I had basically went away when I made the decision to transition, knowing there was a way to at least get closer to who I am solved that...but, apparently because it is so common to be depressed some have questioned my desire and need to transition; which is ludicrous that is the very thing that stopped me from being depressed!  On the other side of it, some people have questioned if I am depressed and not telling anyone, which is infuriating because I know how I feel. If someone in a particular demographic and age group is likely to have high blood pressure but doesn't have it the doctor doesn't just act as if they do.

[Nero]

As for professionals in the field who express such silly opinions I would neither consider them professional nor people who should be working in the area as they are demonstrably too ignorant to perform their duty to their clients.

These are small people who live small lives. I just feel sorry for them and move on.

Ironically, a study on the prevalence of four different mental disorders in children and teenagers was just published a couple of days ago.  Here's the punch line: "Compared to the control group, gender variance was found to be 7.59 times more common in participants with [autism spectrum disorder]. It was also found 6.64 times more often in participants with ADHD."  Here's a link to a summary.  The link to the published research appears at the bottom of the page linked to:

http://www.sciencedaily.com/releases/2014/03/140312103102.htm

This is interesting. I just read the summary, but I wonder if the study showed whether more ftms were on the autism spectrum. We have quite a few here and it would make sense, since autism is said to be like having an 'extreme male brain'.
The prevalence of personality disorders would make sense as well, since gender issues are a factor in some, such as BPD. And of course, growing up the wrong gender could well lead to mental health issues.

[Cindy]

Not a problem, my fault for not being clear originally.

Out of interest most, if not all gender therapy clinics world wide are having an exponential growth in referrals,which is causing major problems,  many new clients are suffering ASD as a primary comorbidity, the degree of effect is of course variable. I have a hypothesis for the exponential growth in referrals that I am testing by questionnaire, that it may be linked by access to supportive websites. At the recent WPATH conference, professionals were astounded by the size of websites such as Susan's; they had no idea that such level of communication existed.

This in itself causes problems, in Asia (my neck of the woods as a professional in Australia) I and my colleagues are wondering how to help 25 million plus transgender people many of whom have internet access but little medical resource except by the sex trade. The social and health issues are profound and myriad.