Stop Trying to "Fix" Trans People

[Julie Marie]

But, correct me if i'm wrong, TS seems to cause trouble even in an accepting culture? And some people require treatment to be content, the most effecting treatment being physical transition?

I see you're trying to get a grasp on something you don't understand.  And I don't want to kick a dead horse but engaging in an intelligent discussion can be beneficial.

An accepting culture would be the Native American tribes before English settlers came to this country.  In that culture they recognized transgender people as being a gift from the gods.  They saw TGs as gifted because they understood both males and females and could communicate with either.  Look up Two Spirit or Berdache and you'll find countless stories about our cultural ancestors.

You will also find none of the Two Spirit had anything physical done to them in order to conform to today's societally accepted physical gender expectations.  They didn't need to in order to lead normal lives (eg: not be discriminated against).  But they also did not have the same surgical procedures we know today.  So it's difficult to ascertain if the lack of availability of gender conforming surgery left them no option or if the way society viewed them (most were revered and given high positions in their tribes) was why they lived their entire lives with their birth genitals without any accounts of the type of dysphoria we hear about today.

Imagine you are born into royalty and seen by your society as being something special.  Why would you want to walk away from that?  Most wouldn't.

But that is not the case today.  Being TG carries a severe and horribly wrong stigma with it.  Those who are TG know this is undeserving.  So we fight it.  We also know we can't change what has taken centuries to develop.  So we take the best option and in the meantime try to chink away at the ignorance.

I can't say if I was born into a culture where being TG was honored or revered would have meant I would have not transitioned.  I'm guessing I wouldn't have.  It would have been a hell of a lot easier.  But that's not the case.  I played the hand dealt to me.  That's all you can do.  But I do know I will work, until the day I die, to make this world a better place for myself and my fellow TGs.

Julie

[metal angel]

Ok... that makes a lot of sense, but it doesn't really fit in with the rest of your posts.

If that's the case, that it is healthy just not typical, to have a masculine mind in a female body, or visa verse, as i am inclined to believe, why are more of you not fighting for the right to live how you please in the body you were born in, rather than fighting for the right to go through the painful and generally unplesant process of physical transition?

Also, from what i read here in this forum, in severe cases of GID there is a certain deep distain for one's own body, which frankly seems kinda - for want of a better word - unhealthy? Or in the model you just presented, is that distain for "that thing between my legs" only analygous to the shame a homosexual would feel about their natural desires 50 years ago?

In which case, it seems you would be much better off fighting for a less gender-stricct world. Be a bit brave, and go out in pretty clothes with your own natural strong jaw line intact, etc. People should have the option to transition, but they should not feel that they "need" to, there shouldn't be this "transition or die" kind of mantra in the TS community.

BUT previously you and others have been adimently claiming that TS/GID is a "medical condition"? Some sort of natural defect which needs correcting? you have the "wrong" body, your entire self - with the exception of your mind and identity - is defective? Is there a contradiction here. Or do some of you feel you are ill and need correcting, while others just do not feel brave enough to live as a lady in a man's body in the current culture?

[Shana A]

If that's the case, that it is healthy just not typical, to have a masculine mind in a female body, or visa verse, as i am inclined to believe, why are more of you not fighting for the right to live how you please in the body you were born in, rather than fighting for the right to go through the painful and generally unplesant process of physical transition?

I want to see both; we should have the right to live as any gender, at any point on the continuum, binary or non binary, with or without surgery/hrt. Without the imposed stigma of mental illness.

What feels right for me (at this time) is living somewhere in between/outside, however I defend the right of my sisters/brothers to do what is right for them.

I can't say if I was born into a culture where being TG was honored or revered would have meant I would have not transitioned.  I'm guessing I wouldn't have.  It would have been a hell of a lot easier.  But that's not the case.  I played the hand dealt to me.  That's all you can do.  But I do know I will work, until the day I die, to make this world a better place for myself and my fellow TGs.

I'm totally with you on this Julie!

Z

[metal angel]

lets use th autism spectrum as an analogy?

I think being unusualy feminine or masculine for your biosex is just part of the normal variation of humanity, and largely a matter of finding a community which will accept you, or changing your own community for the better. Kind of analagous to a geek on the autism spectrum.

But if you are in the state of deeply needing to transition, and dispising your own body, not identifying your body as self, attempting self-mutilation (like the stories of people muutliating their gentials in their bathroom etc.)... then whatever caused that - medical quirk or sick society - that's psychologically pathological. Being feminine or masculine is not pathological, but those other symptoms are. Kind of like when you pass the threshold of geeky into full blown Asperger's syndrome and can't function in your socioty without frequent "autistic melt downs".

Another example even if you can blame culture for a lot of the motivation behind something like anorexia, it still develops into a neurological/psychological disease.

If you just want to transition but still have your free will and can function without it, that's non-pathological, but once you feel you have a medical need to transition there must be some sort of pathology going on.

[Miniar]

Because my physical transition isn't about societies gender roles but my own comfort in my own body.

[metal angel]

that statement is a decent description Miniar, helps me see your view a bit, but what is it a reply to exactly?

[Miniar]

specifically it's a reply to the question

why are more of you not fighting for the right to live how you please in the body you were born in, rather than fighting for the right to go through the painful and generally unplesant process of physical transition?

[Julie Marie]

Ok... that makes a lot of sense, but it doesn't really fit in with the rest of your posts.

If that's the case, that it is healthy just not typical, to have a masculine mind in a female body, or visa verse, as i am inclined to believe, why are more of you not fighting for the right to live how you please in the body you were born in, rather than fighting for the right to go through the painful and generally unplesant process of physical transition?

We are fighting for the right to live our own lives without persecution or discrimination.  We fight for the passage of ENDA and other laws that offer protection but it takes decades to change the tide of societal thinking.  But there still exists the internal battle that can be fueled by simply looking in the mirror.  The person we see doesn't match who we are.

Also, from what i read here in this forum, in severe cases of GID there is a certain deep distain for one's own body, which frankly seems kinda - for want of a better word - unhealthy? Or in the model you just presented, is that distain for "that thing between my legs" only analygous to the shame a homosexual would feel about their natural desires 50 years ago?

In which case, it seems you would be much better off fighting for a less gender-stricct world. Be a bit brave, and go out in pretty clothes with your own natural strong jaw line intact, etc. People should have the option to transition, but they should not feel that they "need" to, there shouldn't be this "transition or die" kind of mantra in the TS community.

When you don't see the image in the mirror as being representative of the person in your heart and soul, you are at least uncomfortable with your physical self.  As we approach someone we are meeting for the first time, each of us will pass judgment, to some degree, on the person we are meeting based on their looks.  The first thing we do is gender them.  And from that we have certain expectations.  If your physical presentation is the opposite of your identified gender, you've done yourself a disservice and created a whole lot of work for yourself to undo what was just done.

To go out into public looking like half man, half woman will certainly cause most people to avoid you.  Why do that just so those who don't understand what's inside us won't feel uncomfortable about our desire to physically transition?  You say "be a bit brave".  There's a difference between that and social suicide and what you are suggesting can be social suicide.

BUT previously you and others have been adimently claiming that TS/GID is a "medical condition"? Some sort of natural defect which needs correcting? you have the "wrong" body, your entire self - with the exception of your mind and identity - is defective? Is there a contradiction here. Or do some of you feel you are ill and need correcting, while others just do not feel brave enough to live as a lady in a man's body in the current culture?

I can only speak for myself here.  I can go back as far as my earliest memory and remember saying to myself, "I wish I was a girl".  That was long before I understood the social implications of being trans.  I knew I wasn't a girl and I knew that I wanted to be one.  It's pretty simple.  The mind and body were in conflict. 

You keep referring to bravery, as if that's all it takes to live the life we feel we need to live.  Would you tell someone who is afraid of a killer bee hive that all they need to do is be brave and walk up there and shake it?  No, because you know the outcome would likely be horrible.  That's not brave, it's stupid.  Suggesting a man walk around femininely attired (my mind thinks of the Redskins' hog fans) is asking for social ostracization, or worse.  You will soon find yourself totally alone.  The killer bee nest might be the better option than this.

I understand you don't understand what it's like being TS.  And it seems you are trying to understand but you are also focusing on things you believe in and not letting go of some ideas and concepts that you need to let go of in order to begin to understand the life of the TS. 

But what you are proving is this is not a condition that can be explained in psychological terms, just as a physical deformity cannot.  And that's what you have to accept in order to understand transsexualism.  It's not a psychological problem, it's a physical problem.

Once you can explain why the woman who is dysphoric, because she has a disfigured face she was born with, has a condition that can be cured through psychotherapy, then we can begin to discuss how to "fix" TSs.

Julie

[metal angel]

I get your point from your drawing, but you can be a bit creative, you can be feminine without wearing things that don't suit you, don't wear a short skirt with hairy legs just like a woman who is over-weight should stear clear of hipster jeans.

The problem is in diagnostics, no-one - or almost no one - would want a cleft palate or missing nose. But most people who have XY chromosones want to look like a normal healthy male, there is a minority who do not, but the difference is not definable by any physical assessment.

Yes there is a solcial component, but the reason people feel the need to defy that social pressure is to do with the brain (call it "neurological" if you don't like "psychological") even if the pathology is social it is a definable trait of the individual best defined in the mind/brian?

Also there is some internal non-social component - the wrong face in the mirror effect. I guess the psychological effect of a deformity kind of makes sense, but some people would be happy with that face, or maybe just want it to be more handsome, again the difference is in the mind, and it's one that can only be detected by talking to the sufferer.

Feminine males, crossdressers, etc. are all just part of the spice of life, some of them may even decide to transition if they feel they canm better express themselves in that body and already have kids or don't want kids. But when people feel the need to transition, when they stop identifying their body as "self" that's a pathology of some sort. It could be very organic and neurological "wrong body map in the brain", but plenty of things in the DSM are very obiological (not enough of this or that neurotransmitter, or too much).

I think it's probably wrong and counter productive to have a gate keeper approach to surgery. Mainly because that leads to a patient giveing the "right answers" to get what they want, and that doesn't help anyone. It should be personal choice, people should not be excluded from transition for having different reasoning to "true" transexuals, mainly because so far the conditionis so poorly defined (exacerbated by people giving "right answers") that we can't know what on earth a "true transsexual" is.

But i think some sort of councilling is useful, to assess whether the procudure is in the patient's best interest. Just to check they are not a self-hating homosexual or totally psychotic. And to help them make an informed dicision for themselves. and to help them deal with the stress and social pressure of being mid-transition, which - as shown by your picture - must be quite stressful.

Also we need to define the phenomenon somehwere and somehow to study it. Quicker diagnosis of GID and who would benifit from transition may eliminate the stressfull step of the years of the "real life test. Better evidence for the benifits of transition may assist in arguing for better funding for it. Undertsanding unusual conditions like GID may help us understand and treat more widespread problems like the stress of having sexual organs removed because or cancer.

Also to me it seems at least a little selfish to get expensive surgery to fit in how you want to behave, rather than fighting for a better world... but if it's also organic/neuroligical it makes a bit of sense. (But hey everyone's selfish, i spend money on coffee while people around the world are starving.) I also worry that people who would be better with another approach feel a bit pressurred into full transition by the community by a narrow approach to the problem.
Post Merge: September 01, 2009, 07:45:36 PM
and i'd keep my beard, the neurological conddition your electorlosist sufferrs from is the opposite of mine, i am excessively autistic, she is deficiently autistic... i'll find the definition for it some time, it's partly a joke, but makes an interesting point. 

[Julie Marie]

Well, from here on out it's probably just you and me, kid.  But that's okay.  You seem intelligent and really trying to get into the nitty gritty of transsexualism.  Who knows, maybe someday your work will lead to a groundbreaking discovery.  But then again, it may go the way that all the homosexual studies have.  Who knows?

Here's an exercise to stimulate your thought neurons - Let's say a person walks into a surgeon's office and says, "I hate my nose!  Everyone makes fun of me.  They look at me like I'm a freak.  I want it fixed!"

The surgeon looks at the nose and tells the patient his/her expectations can be realized.  The patient pays for the surgery, it is a success (as decided by the patient) and suddenly the patient, this person who hated his/her looks, is happy, outgoing and productive.  No more funny looks.  No more jokes behind his/her back.  Everyone raves how good he/she looks.

Would you call that a success?  Would you see that as a positive thing?  Would you be willing to say it's reasonable for medical insurance to cover such a procedure because the end result is someone who is happy and productive in today's society?

Or would you try to get that person into psychotherapy and analyze them, encourage them to see things from your perspective and ultimately try to get them to like themselves as you wish they could?

Or would you just say, "If that's what makes you happy, I see no problem with that."

Just curious.

Julie

[tekla]

Suggesting a man walk around femininely attired (my mind thinks of the Redskins' hog fans) is asking for social ostracization, or worse.

Unless of course you're at a Washington Redskins game, in which case you'll be one of the most popular person there.  Everything depends on situation after all, I can dress in stuff for work that few, if anyone else, could wear to work.  Girl stuff, shirts with the F word printed on them in large letters, shirts with naked women on them, it's all just rock and roll.  If I were a cubicle clown, I doubt if my boss would find it funny if I wore a shirt to work that said (as one of mine once said): "->-bleeped-<- you you ->-bleeped-<-ing ->-bleeped-<-."  But most things are situational.  What you wear to a beach in Chicago will get you arrested in Dubai.  Different strokes for different folks.

will certainly cause most people to avoid you
Get back to me on what that's a bad thing.  Most people should be avoided, and if you can get them to do that on their own, more power to you.

[metal angel]

Unless of course you're at a Washington Redskins game, in which case you'll be one of the most popular person there.  Everything depends on situation after all, I can dress in stuff for work that few, if anyone else, could wear to work.  Girl stuff, shirts with the F word printed on them in large letters, shirts with naked women on them, it's all just rock and roll.  If I were a cubicle clown, I doubt if my boss would find it funny if I wore a shirt to work that said (as one of mine once said): "->-bleeped-<- you you ->-bleeped-<-ing ->-bleeped-<-."  But most things are situational.  What you wear to a beach in Chicago will get you arrested in Dubai.  Different strokes for different folks.

Actually that's kind of what i've been suggesting a bit round here. People who can live with their body themselves but feel they can't play the role they want to in it need a new culture moore than a new body. Get a job in a reserach lab, or some other part of a university, or in rock music, find some new friends you can be yourself around, pleanty of places in the world where no one gives a hoot if you're a man dressing or acting like a woman.
Post Merge: September 02, 2009, 12:30:01 AM

Well, from here on out it's probably just you and Here's an exercise to stimulate your thought neurons - Let's say a person walks into a surgeon's office and says, "I hate my nose!  Everyone makes fun of me.  They look at me like I'm a freak.  I want it fixed!"

The surgeon looks at the nose and tells the patient his/her expectations can be realized.  The patient pays for the surgery, it is a success (as decided by the patient) and suddenly the patient, this person who hated his/her looks, is happy, outgoing and productive.  No more funny looks.  No more jokes behind his/her back.  Everyone raves how good he/she looks.

Would you call that a success? Would you see that as a positive thing?

I guess so, for that individual, it's a reasonable course of action if they can afford it. It's not the way i'd do it for sure, but if the patient is genuinely improved in outlook/productivity it may be good for them and those around them.

Personally the i like the world's natural variety (my partner has a slightly crooked nose and i think his nose is just perfect, it is unique, i think it is one of his most attractive features), but it effects the patient more than me so it's their choice.

Would you be willing to say it's reasonable for medical insurance to cover such a procedure because the end result is someone who is happy and productive in today's society?

I guess for privbate insurance there should be consumer choice, some policies which fund cosmetic procedures and some which don't, with the difference in cost reflected in the premiums. But i'll take about a public health system perspective because that's what i'm familiar with. There are many reasons why public health systems should not fund plastic surgery. A few of these reasons kind of inter-relate but i'll try to break it up.

It is too expensive, and there are higher priorities. It may help the patient but i don't think any genuine improvement has been sufficiently demonstraited to justify the expense at a population level (see below re psychology). But if the patient is willing to pay for it they should be able to obtain it privately under safe conditions which are monitorred by public health autorities.

It is not correcting a functional deficit, the purpose of healthcare is to treat disease, not to beautify and normalise. If they had trouble breathing, eating, or speaking it is a pathology to treat, if not, it's just aestetic and kind of a lusxury/low priority.

There is a bit of a grey area here of social exclusion, facial deformities can cause people a lot of trouble. If they lacked a nose entirely or it hung down past their chin etc. it may be justifyable to fix it at public expense. I guess the cut off i'd place on it would be whether the nose is one that someone else would possibly be happy with. But i think even if they have a very unsual facial feature, care should be taken not to make them feel compeled to change it.

The compulsion to change it is abnother reason i would be reluctant to publically fund plastic surgery. If the health system deems having a nose with a bit of personality sufficiently pathological that they willing pay to change it, that puts undue pressue on people to look "normal" and idealised. It puts more psychological pressure on those who would not otherwise want to change. I get this kind of worrying vission of going outside and everyone looks like barbie... very expsensive, and probably not a healthy culture.

If they have a "normal" functional nose but it causes a functioal deficit psychologically to the degree where they cannot get on with life, I confess i am not a psychologist, but i would say that this is a psychological illness. It is actually a sign of what my foggy memory tells me is called "body dismorphia", and to the best of my memory this is a sign that the patient will not benifit from surgery. I would actually consider this sort of symptom possible grounds for not allowing that patient go through with surgery even at their own expense untill they have tried psychological cures. a body-dismorphic patient usually isn't happy with fixing just one part and will often get so much surgery that they end up with actual deficits in physical function. (I'm pretty sure that's in the DSM, but i forget where to find the on-line copy of it on my uni website...)

Actually to me transsexualism seems slightly similar to body dismorphia? Except transsexuals more often benifit from surgery than body dismorphics do. I think this would be due to the different goals. Transsexuals feel the need to be the other gender, their goal is usually to look like a "passable" member of the opposite sex, so there is kind of an end in sight for their surgery, they have a somewhat acheivable goal. Whereas a body dismorphic patient seeks to look "perfect", they have a less acheivable goal, and will likely not be satisfied by any amount of surgery.

Or would you try to get that person into psychotherapy and analyze them, encourage them to see things from your perspective and ultimately try to get them to like themselves as you wish they could?

I think that should be an option for them, but i don't think they should be compelled to go for councilling if they don't want it.

I don't think it's worthwhile doing any extensive patient screening councilling for a minor procedure like a nose job (except possibly in the case of suspected dismorpihia where some councilling may be required before surgery is offerred as an option), but i think they should (and do?) have a discussion with the patient about any risks of surgery, their reaons for wanting it, and whether the results are likely meet their expectations.

I would also think that councilling - if they were willing to co-operate - may be more worthwhile on a public health level on a cost/benifit basis. I don't know what a new nose costs but a psychologist costs about $100 to $150 (Australian) per session. So 10 sessions at $100 each ($1000) may be worth a shot if they can show the same effect as nose job because they are probably more affordable (I assume a nose job is more than $1000), and there is pretty much no risk to the patient whereas surgery carries some health risks, and psychology may treat any underlying self-exteem issues etc. which the nose job would not.

Or would you just say, "If that's what makes you happy, I see no problem with that."

Up to personal choice. If it genuinely makes them happy it's up to them.

But, like i said above, i think they should pay for it out of their own pocket, because it's not a high priority, it's not correcting an actual defect, and the benifit per expence has not been adequately demonstraited on a population level.

Just curious.
Julie

Post Merge: September 02, 2009, 01:32:05 AM
Actually distinguishing transsexuals (who often benifit from surgery) from body dismorphics (who generally do not) is one of the reasons to keep both in the DSM.

Actually i reckon they should put homosexuality back in, just with a big headding saying "normal variation: no treatments required or available".

[Julie Marie]

Actually i reckon they should put homosexuality back in, just with a big headding saying "normal variation: no treatments required or available".

Be careful where you say that.  You could get your head taken off.   

[metal angel]

Read the wole sentence.

I think the DSM should be expanded to include normal variations, not just pathology, i can't think of any other examples though except vague personality types. My main point of having some of the normal variation in there is that it may reduce the stigma of GID and other things being "in the DSM".

The sub pathological range of a lot of conditions is in there implicitly, maybe make that a bit more explicit, it would help to better define the pathology. Like separating healthy perfectionism from OCD.

I really can't think of any healthy variation in humans which is as distinct as homosexuality which isn't in the DSM though. Can you? (Genuine question i'm stumped and curious)

GID probably belongs in there so it can be distinguished from conditions like body-dismorphia and psychotic delusions. A way to define those who may benifit from medical treatment (because no biological tests exist). Being free socioty etc. patient chooses treatment, but medical professionals should advise and guide.

Unless there is an imminent risk of death, the way to define a disease as opposed to normal variation is just whether it bothers the individual and interfears with them getting on with life.

Separating off a portion of the human race as defective is just fascist. That was my point. Having a book of pathologies in something as foggy as the mind is maybe a bit of a flawed mission from the start, why not turn it into a book of variations. With notes on how to deal with the dificulties some of them may cause in extreme cases.

I have a bi-polar friend who has a mild case and doesn't medicate it because she thinks the manic phases are better than being normal at times. She tends to just monitor it to know how to live with it, and control her intake of recreational drugs to keep it in control (e.g. no coffee when manic). So lets take bipolar out of the DSM...

I have Asperger's syndrome, but i don't need meds (i don't even think there are any) and i get on in life a lot more successfully than a lot of "normal people" (higher grades at school, pretty easy time finding jobs etc.), i just need a few extra/different skills for coping with day to day stress... OK Asperger's is out of the DSM...

I show some OCD symptoms but my constant checking means i never loose my wallet... OCD goes out of the DSM...

Being depressed after a death in the family is perfectly normal... so that goes out of the DSM... continued or unprovoked depression is a medical condition caused by a chemical imbalance in the brain... depression goes out of the DSM... (and someone had better work out quick a biological test for that biological problem to keep the suicide rate down...)

Some people hear voices but can learn to live with it and even find it helpful and comforting. There is a group called "hearing voices" who support this ... audable delusions and skitzophrenea go out of the DSM....

getting to be a rather skinny book isn't it?

Homosexuality almost never causes any problems in it's own right without the help of an intollerant culture, so it's ambiguous as to whether there's a point having it in there at all. There is not really such thing as "extreem" homosexuality when it turns pathological. It might be useful to have it in there with "normal variation: no treatments required or available" to emphisisse that it is perfectly healthy and distinguish it clearly from things which can casue more problems, and it can be a distinct trigger of distress e.g. if the person also suffers from the delusion of there being a supreem being who hates them. Just a thought.

GID does seem to belong in there though. Though some people are happy to cross-dress etc. and some people pragmatically take extreem measures (surgery etc.) to fit into an unaccepting gender binary world. Some people seem to have distress caused just by the GID itself ,without much in the way of obvious social pressuere. Those who define it as a "medical condition" and feel they require corrective treatment. Untill someone finds a way to see this elusive "wrong body map" or whatever the cause might be, the only way to diagnose this medical condition is psychologically.
Post Merge: September 02, 2009, 10:46:49 PM
homosexuality and asperger's do seem kind of analagous actually... there is no extreme homosexuality which is equivilent to autism so the similarity is not total, but to me there seem like a lot of similarities in that it's a normal variation which can cause trouble in an unaccepting society.