Stop Trying to "Fix" Trans People

[tekla]

e.g. a lot of crossdressers would not need or benifit from gender reassignment
Yeah, but I doubt if most of them are asking for it either.  I'm sure that many have thought about it, but backed away, and others took the hormones and let it ride at that, others who just did plastic surgery.  Most people, by they time they really get to GRS have given it a lot of thought.  And 'a lot'?  Does that mean that some crossdressers might need and benefit from GRS, 'cause I think that might be right, in some conditions.

And, There's no real way to "diagnose" homosexuality.
Oh come on now, there sure is.  Are you engaging in homosexual activity?  If yes, then you are.  Are you attracted to members of your own gender, even though you might not have ever done anything like that, except masturbate/fantasize about it?  If so, then maybe (I'm not totally sold on the idea that fantasy alone makes it so, I'm not sure that having self play sessions while thinking about some S&M deal, makes you an S&M person - not till you do it can you really own it and be it.)

[metal angel]

And, There's no real way to "diagnose" homosexuality.
Oh come on now, there sure is.  Are you engaging in homosexual activity?  If yes, then you are.  Are you attracted to members of your own gender, even though you might not have ever done anything like that, except masturbate/fantasize about it?  If so, then maybe (I'm not totally sold on the idea that fantasy alone makes it so, I'm not sure that having self play sessions while thinking about some S&M deal, makes you an S&M person - not till you do it can you really own it and be it.)

I meant there is no TOOL for diagnosing homosexuality psychologically (i.e. no diagnostic guideline, no DSM entry) because there is no NEED for it. If a person engages in seme-sex sexual activity it has some inpact on which STDs they may be at risk of and which body parts might be worth swabbing if they want a full STD screen, also if your lesbian patient only engages in sex with other women, you can rule out pregnancy. But there is not STANDARDISED clinical way to assess homosexuality psychologically because you don't need to. I most cases you just go by behaviour "have you had sex with another man in the last 12 months?". You only need to quantify the underlying psychological trait if you are doing psych research, in which context you use a zero to six scale called the kinsey scale (and there are psychometric tests to quantify this). This - i think - is why homosexuality is not in the DSM.

But if a person wants radical medical treatment (e.g. gender reassignment) there is a "duty of care" to determine whether they will benifit from this. So there needs to be a clinical guideline (including a DSM entry etc.) for assessing patients. Even if almost no patients who would not benifit demand the treatment, there is still a risk, even if we accept that 98% benifit from surgery/hormones from that stat quoted before, there's still the remaining 2% in that don't. It's worth a tiny bit of annoyance for the 98% in order to redirect the 2% into treatment which will be more suitable for their condition, given the surgical/hormonal route has quite high risks and the surgery is irreversable.

[juliekins]

No, there are certain thoughts and behaviors that pretty well mark it.

As there are with being trans.

And no one is really trying to fix gay people - outside of a few oddballs - so its a self defined sexual preference, not a DSM category.

But when it was in the DSM, most people thought gays needed fixing.  That's why removing TG from the DSM is an important step to getting people to realize we don't need fixing.

[metal angel]

But you seem to think you think you have a problem of some sort? it seems to troubles you, and you seem to want a solution? it is a problem related to your body, so how or why is it not an illness? and untill there is some biological test (blood-test, brain-scan etc.) why is it not appropriate to descibe the illness in the only way it can be described, by psychology and behaviour?
Post Merge: August 27, 2009, 08:40:33 PM
You say there are thoughs and behavious which mark it, but that is exactly what they are looking for qwhen they define it in psychological guidelines. What else do you think they are doing? for example in this questionare in a paper from Zucker (i was looking into what he's been working on, there are probably heaps of others out there). It's just a way to better quantify the problem, and help to guide people towards solutions (bodily modification if that's what will make the patient happy) that will help them.

Male Version
01. In the past 12 months, have you felt satisfied
being a man?
02. In the past 12 months, have you felt uncertain
about your gender, that is, feeling somewhere in
between a man and a woman?
03. In the past 12 months, have you felt pressured by
others to be a man, although you don't really feel
like one?
04. In the past 12 months, have you felt, unlike most
men, that you have to work at being a man?
05. In the past 12 months, have you felt that you
were not a real man?
06. In the past 12 months, have you felt, given who
you really are (e.g., what you like to do, how
you act with other people), that it would be better
for you to live as a woman rather than as a man?
07. In the past 12 months, have you had dreams?
If NO, skip to Question 8.
If YES, Have you been in your dreams?
If NO, skip to Question 8.
If YES, In the past 12 months, have you had
dreams in which you were a woman?
08. In the past 12 months, have you felt unhappy
about being a man?
09. In the past 12 months, have you felt uncertain
about yourself, at times feeling more like a
woman and at times feeling more like a man?
10. In the past 12 months, have you felt more like a
woman than like a man?
11. In the past 12 months, have you felt that you did
not have anything in common with either women
or men?
12. In the past 12 months, have you been bothered
by seeing yourself identified as male or having
to check the box ''M'' for male on official forms
(e.g., employment applications, driver's license,
passport)?
13. In the past 12 months, have you felt comfortable
when using men's restrooms in public places?
14. In the past 12 months, have strangers treated you
as a woman?
15. In the past 12 months, at home, have people you
know, such as friends or relatives, treated you as
a woman?
16. In the past 12 months, have you had the wish or
desire to be a woman?
17. In the past 12 months, at home, have you dressed
and acted as a woman?
18. In the past 12 months, at parties or at other
social gatherings, have you presented yourself
as a woman?
19. In the past 12 months, at work or at school, have
you presented yourself as a woman?
20. In the past 12 months, have you disliked your
body because it is male (e.g., having a penis or
having hair on your chest, arms, and legs)?
21. In the past 12 months, have you wished to have
hormone treatment to change your body into a
woman's?
22. In the past 12 months, have you wished to have
an operation to change your body into a
woman's (e.g., to have your penis removed or
to have a vagina made)?
23. In the past 12 months, have you made an effort
to change your legal sex (e.g., on a driver's
licence or credit card)?
24. In the past 12 months, have you thought of
yourself as a ''hermaphrodite'' or an ''intersex''
rather than as a man or woman?
25. In the past 12 months, have you thought of
yourself as a ''transgendered person''?
26. In the past 12 months, have you thought of
yourself as a woman?
27. In the past 12 months, have you thought of
yourself as a man?

This is more designed to quantify the magnitude of GID for research, but the one in the DSM would be similar except it would be designed to characterise people in a more binary sense, "has GID" or "does not have GID". I should find the a copy of the DSM to show you. I really don't think your objection makes sense.

[Julie Marie]

I meant there is no TOOL for diagnosing homosexuality psychologically (i.e. no diagnostic guideline, no DSM entry) because there is no NEED for it.

Well, there used to be a tool in the DSM and you can go back to that time and use what they did then if you want to "diagnose" homosexuality.  But if I understand you correctly, since homosexual behavior is no longer in the DSM there is no need to diagnose it.  That's why TG should be removed, so people will stop diagnosing us and start giving us the medical treatment we need, covered by insurance.  Doctors will still require the two letters to cover themselves but at least our surgeries will be covered by insurance.

But if a person wants radical medical treatment (e.g. gender reassignment) there is a "duty of care" to determine whether they will benifit from this. So there needs to be a clinical guideline (including a DSM entry etc.) for assessing patients. Even if almost no patients who would not benifit demand the treatment, there is still a risk, even if we accept that 98% benifit from surgery/hormones from that stat quoted before, there's still the remaining 2% in that don't. It's worth a tiny bit of annoyance for the 98% in order to redirect the 2% into treatment which will be more suitable for their condition, given the surgical/hormonal route has quite high risks and the surgery is irreversable.

So you're saying because there's 2% of the TS population that might regret transitioning the rest of us need to endure testing, psychotherapy, years of waiting and who knows what else even though it isn't necessary for us?

While I believe it is advisable for someone to enter into therapy and give transitioning very serious consideration, if that same person wants to march into a surgeon's office, sign on the dotted line and plop down the cash to have their genitals revamped, I say let them.  What right do we have to intervene in their lives as long as what they do doesn't hurt us?  They can have FFS and BA without psychotherapy, why not GRS?

The idea we have to achieve 100% success is socialism on steroids. To say the 98% have to jump through hoops so we can weed out the 2% is simply taking things way too far.  If you're not certain you want to transition, then DON"T!  It's pretty easy.

It's a free country.  But it won't be if we keep trying to intervene in and control the lives of others who want us to mind our own business.

Julie

[Janet_Girl]

@ Metal Angel  Why are you asking these questions?  There are already guidelines to the treatment of Transsexual.  And it is called the Standard of Care.  And the AMA as already stated that the health care industry needs to cover all of our medical issues in the AMA Resolution 122.

What is now needed is for the medical community and the health care industry to adopt the resolution and begin offering the needed hormonal therapy and medical surgeries.

Janet

[heatherrose]

Yeah, but I doubt if most of them are asking for it either.  I'm sure that many have thought about it, but backed away, and others took the hormones and let it ride at that, others who just did plastic surgery.  Most people, by they time they really get to GRS have given it a lot of thought.  And 'a lot'?  Does that mean that some crossdressers might need and benefit from GRS, 'cause I think that might be right, in some conditions.

This is a very good point. What are the current numbers of individuals,
having jumped through all necessary hoops and proven themselves acceptable
candidates, who are now dissatisfied with the outcome of their SRS? What is the
criteria which is used to measure the effectiveness of a given treatment? Being
someone who has found herself neck deep in the mind foch, commonly referred to
as GID, I can only venture a guess to say that the first indication that a course
of treatment is successful, would be whether the subject has been able to
achieve a level of peace of mind which they did not have before.

As I wade through the scary cobwebs in my attic, I understand and
appreciate the need for the level of difficultly of obtaining "medical" treatment
as it currently stands. What I do not understand is the reoccurring fascination
with courses of "treatment" which have proven themselves dismal failures, over and
over. The problem with the "treatments" administered by well meaning psychiatric
professionals in the past, rendered for homosexuality and by extension transsexualism,
is that the efficacy of that particular course of therapy was determined by how well
the square subject could force themselves into society's round hole. A treatment
which demands that I once again internalize my femininity. A treatment which
some here seem to happily subject themselves to and are now trying to
present it as a SHINY, NEW and IMPROVED theory.

[LordKAT]

and the sooner the better. It makes no sense to not cover something that is described as "a serious medical condition recognized as such in both the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) and the International Classification of Diseases (10th Revision); and is characterized in  the DSM-IV as a persistent discomfort with one's assigned sex and with one's primary and secondary sex characteristics, which causes intense emotional pain and suffering;"

[Genevieve Swann]

Some ignorant persons whom have been programmed by their culture and religion have opinions concerning gender needs. It can't be "fixed". 25  to 40 years ago a lobotomy was the option and thank God that is no longer allowed or we would be in big trouble. If an individual is told they have a disorder for long enough it becomes a disorder. Simply brainwashed by society. I agree 100% with Janet Lynn. Give me about $100,000 and I will fix it and give them change back.

[metal angel]

Well, there used to be  But if I understand you correctly, since homosexual behavior is no longer in the DSM there is no need to diagnose it. 

Other way round, becuase there is no need to diagnose homosexuality they don't need it in the DSM.

That's why TG should be removed, so people will stop diagnosing us and start giving us the medical treatment we need, covered by insurance.  Doctors will still require the two letters to cover themselves but at least our surgeries will be covered by insurance.

The problem in your argument here is that you can't claim medical treatment (especially not payed for by insurance or payed for by the governemnt) unless you have a diagnoseable illness to treat.

Untill someone comes up with a way to diagnose transexuality medically the only way to diagnose what you want to be treated for is psychologically.

Post Merge: August 28, 2009, 02:29:31 AM

@ Metal Angel  Why are you asking these questions?
Janet

i don't see whats wrong with in being in the DSM? these days you can only be forcably committed etc. and made to endure pschological treatment if you are violent. what are you scarred of?

[heatherrose]

Yeah the people in that Dr Phil clip probably are quacks... which is about what i'd expect from Dr. Phil. I couldn't catch the name of the other one, but i can't find any legitimate research from the Glenn stanton guy. I guess if he is a cliniitian you wouldn't expect much research... but i wouldn't really judge any group by their representatives on day time TV.

Glenn Stanton is a "family researcher" associated with "Focus on the Family"
and the other, more vocal, individual is (quoting from wikipedia)"Joseph Nicolosi,
an American clinical psychologist, founder and director of the Thomas Aquinas
Psychological Clinic, in Encino, California, and a past-president of the National
Association for Research and Therapy of Homosexuality. Nicolosi has advocated
and practiced reparative therapy" and is co-author of, among other
loads of stuff, "A Parent's Guide to Preventing Homosexuality".

Normally, I would dismiss a guest of "Dr. Phil" purporting to be an expert in
this or that field, as a "quack" except as in this case where the individual is not
simply a talking airhead. Nicolosi, is a published author, who offers a "service"
which he touts as successful, availible to any parent hanging by their
last nerve over how to deal with a trans(blank) child.

While I do know that there is nothing that I can do to prevent
this individual from spouting his tripe, I feel that it is incumbent
upon all of us to identify our opponents and prepare ourselves
for attacks which may be spawned by their rhetoric.

<sup>"* cured by materialism!"

"Cure" as in relief of a medical condition or
hardening or solidification of a material?</sup> 

[metal angel]

I agree 100% with Janet Lynn. Give me about $100,000 and I will fix it and give them change back.

You can have that $100,000 and keep the change for a new wardrobe to fit your new body if you are treating an actual medical condition. But if you do not have an illness to treat then it's just plastic surgery, a luxury you can pay for by yourself.

If it is a matter of just wanting to be the other gender, then fair enough, it's your body, do what you like with it and pay for it yourself. But in every other context TS people insist that it's a medical condition, and insist that it's far more than meerly "wanting" to be the other gender?
Post Merge: August 28, 2009, 12:42:52 AM
i'm not supporting the foccus on the family types, i think they are as nutty as you think they are, i have pretty much zero tollerence for religious nutters.

i am defending the psychologists who asses people for SRS, and the researchers making a genuine scientific attampt to understand GID and improve treatment outcomes.
Post Merge: August 28, 2009, 01:49:56 AM
I definately DO NOT think that children should be forced into the social roles of their biological gender, but i also slightly worry that the TS community forces some people into bodies to match their behaviour, when at least a few of them may have been happier learning to love their body as it was and just being a feminine male/masculine female.

I guess on a personal level i am not totally comfortable with my gender, but i have an ideological objection to surgery and i am sure it wouldn't fix me. I think i could do with a good shrink really. I mean body modification is not right for me, other adults can choose it if they wish, and i'll happily pay the bill through my taxes if it is treating an illness. 

Maybe i'm just a bit bitter/disapointed that this comunity doesn't seem to be able to offer much advice except body modification, since i know that is not right for me.
Post Merge: August 28, 2009, 03:26:42 AM

they can have FFS and BA without psychotherapy, why not GRS?
Julie

They key difference is that FFS and BA are both entirely superficial and there is no loss of functionality, unless their are unexpected complications from the surgery but with a decent surgeon the risk is small enough to be considerred a reasonable personal choice.

With SRS (and to some extent hormonal treatments) there is a loss of functionality, mainly fertility, but also hormonal function.

Also BA and FFS would be at least partially reversable, whereas SRS removes tissues (the main one being the testicles, but also the erectile tissue of the penis) which are impossible to replicate the full function of with prostetics.

You may know it's what you want and you may have thought it through, but as responsible medical professionals they have a "duty of care" to confirm that every patient really has thought it through before they remove healthy organs.

[Janet_Girl]

The only thing I am afraid of is one else telling me what to do with my body and my life.  It is the same as it was with homosexuality.

There is nothing wrong with mt mind, it is the body.  And the is already a guideline for treating Transpeople, and it does not include shock therapy or being beaten down to conform.  Beat a dog enough, don't be surprised if it turns on you.  I don't need to conform to someone elses view of what I should be.  I did that and it nearly cost me my life.

Is that what I should do?  Commit suicide because they don't want me to be me?  BS.  Why must we be cured of this.  There is already a methodology in place to handle it.  And that is transition, HRT, BA, FFS, and finally SRS.

Just because you are not comfortable with you, why should that be a reflect of me or anyone else?

Get thee to a gender therapist and find your own 'cure'.  I have mine.  The only thing I ask is for the medical and heath care industry to follow the AMA resolution and cover it as they do any medically necessary procedure.

And as far as the children are concerned, they know that they a different.  Why should they be forced into a mold that they know is wrong and doing so will cause unrepairable damage to their young psyche.

Janet

[metal angel]

your views on psychiatry are a few decasdes out of date, there are a few religious nuts trying to make people fit into moulds, but the grater majority of people working in psychology and psychiatry are trying to help them to be happy and well adjusted in whatever way seems most effective.

DSM stands for "diagnostic and statistical manual". Just think of it as a dictionary of all the medical conditions that you need to talk to the patient to diagnose, all the ones you can't detect with a blood test or scan? The entry may not even be used very much if patients can effectively self-diagnose, it's just kind of like an encyclopeadia of what's out there, all the different things that may destress a mind.

It seems to be the problem/illness is a missmatch. There is a healthy body, with an arguably healthy (but rather destressed) mind living in it. The problem is that they don't match. I can see why you want to treat the body rather than the mind, the mind is more "self", and out of psychiatric drugs VS sex hormones; genital surgery VS brain surgery; i'd probably change the body as well. But unless there is a way to diagnose it from the body's perspective, a psychological diagnostic definition seems appropriate.

Please stop accusing me of trying to make you conform to male behaviour. I think in an ideal world a feminine mind should be able to behave how comes naturally in a male body and be accepted for it. I think a healthy mind in a healthy body which are just a bit incongruous would be optimally treated by just making them get along with each other.

If the best way to makle you content is to get SRS then i think you should have that as easily as treatment for any other medical condition. But in order to provide health care in an organised and effective way, we need to define what we are trying to solve. Clear definitions of the condition being treated could help to demonstrait the success of treatment (HRT, SRS, etc.), which would help improve access to treatment.

Effective studies which examine and quantify the stress which GID causes is reduced by the treatments you seek it will help to convince health insurers and governments to help you pay for the treatment you want.

[Janet_Girl]

I have dealt the modern psychiatry, and none of them seem even remotely interested in helping me.  They give me anti-depressant drugs and books on everything else under the sun, but none of them have even talked about GID.  And that is why I am so against yet another document that avoids the issue.  The standard of care is the only guide that truly deals with the core issue.

The psychiatrists need to help the Trans community instead of trying to cure us.  SRS is not a 'cosmetic' surgery in the same vein as a face lift or even a BA.  Yes it is cosmetic in the fact that it improves the look of a certain part of the body. 

But if a person, who is horrible disfigured at birth, requests a facial surgery is it not to improve their outlook and life?   And it is cosmetic?  No, it is a necessary surgery and is generally covered by insurance. I was born with such a disfigurement and I am only wanting to be covered as the person in the example.

I have a diagnosis of GID, but the necessary surgery is called 'cosmetic', because the health care industry does not wish to cover it.  As I said in another thread, it is all about the bottom line and not taking care of the patient.

No one is accusing me of trying to make you conform to male behavior.  But many in the  psychiatry field do and mostly it is because of their views on Transsexuality and homosexuality.

Janet

[Julie Marie]

The problem in your argument here is that you can't claim medical treatment (especially not payed for by insurance or payed for by the governemnt) unless you have a diagnoseable illness to treat.

My electrologist was hirsute.  A genetic female, she had to shave sometimes twice a day.  She had no physical problems, only the social problems with having to grow up a female with a beard.  Her insurance covered all of the electrolysis she needed to remove her facial hair.

Hirsutism was not in the DSM but she received the medical treatment she needed anyway. 

The AMA has already gone on record encouraging insurance companies to cover GRS.  That's the kind of direction we should encourage, not being in the DSM.

When your "condition" is listed in the DSM people think you have a mental problem.  I don't and I never have and I don't want some book to say I do.

Julie

[Shana A]

<Z puts on stylish admin hat>

A reminder, expressing differing opinions and debating the issue is fine, but no personal attacks or thread will be locked!

Z

[metal angel]

what was the personal attack exactly?

i thought i was sticking relatively well to attacking opinions rather than people, was i?

Post Merge: August 28, 2009, 10:18:09 AM

My electrologist was hirsute.  A genetic female, she had to shave sometimes twice a day.  She had no physical problems, only the social problems with having to grow up a female with a beard.  Her insurance covered all of the electrolysis she needed to remove her facial hair.
Julie

Well that's another miss-match problem, her beard did not match the rest of her body, but in that case both are easily recognised externally.

When all parts of the body that are biologically measurable match, but just don't fit the mind, it makes sense to have a psychological definition.

It may not even effect treatment on an individual basis, but it is useful to assess treatment outcomes etc. and therefor we need a definition for the condition?

And just FYI, can we lay off the stigma about mental illness please! I have quite a few friends and family who's problems are in the DSM, and they shouldn't be thought any less of than someone with a condition that isn't!

[placeholdername]

who made a personal attack?

In your above posts you say that in order for TG/TS people to claim medical insurance they have to have a diagnosable illness, and therefore it should be in the DSM.  I think you've been using the acronym too much and forgot what it stands for: Diagnostic and Statistical Manual of Mental Disorders.  "Mental Disorders" is a very stigmatized word, and I think most of us in this community would argue that TG-ness is not a mental disorder at all.

This does not mean it is not a medical condition that requires treatment, it just means its not a mental disorder.

Your specific quote was:

DSM stands for "diagnostic and statistical manual".

That's where you are making the mistake and perhaps not realizing exactly what you are implying when you say Transsexuality should be in the DSM.


edit:

And just FYI, can we lay off the stigma about mental illness please! I have quite a few friends and family who's problems are in the DSM, and they shouldn't be thought any less of than someone with a condition that isn't!

Just because something shouldn't carry stigma doesn't mean you can ignore that it does!  A Mental Disorder, stigmatized or not, is still something that needs to be *corrected*, which most Trans people do not want!  We do not want to be 'corrected' or 'fixed', just the freedom and opportunity to be who and how we want to be.

[metal angel]

Ah well the D stands for diagnostic, the S stands for stastistical, and the M stands for manual, Sorry i left off the last two letters, but i thought that was pretty well implied. I mentioned repeatedly that it was for problems which involved the mind.

I have two problems with the vibe i am getting here:

1. What is so bad about having a mental disorder?!?!? like i just said, some of my best friends do. You complain a lot about stigma, so don't perpetute stigma for other groups!

2. You can argue that the mind is healthy but just missmatched with the body which is also healthy. But we can't have one set of books with mind problems, another with body problems, and have the missmatch in a category by itself. A comprehensive list of problems with sexual organs would include cases where they do not match the identity, a comprehensive list of problems with minds would include cases where they are in the wrong body.
Post Merge: August 28, 2009, 12:31:40 PM

Just because something shouldn't carry stigma doesn't mean you can ignore that it does!

But can we at least try not to perpetuate the problem, please. This every minority for themselves thing is not going to help anyone.