Susan's Place Transgender Resources

I have been a member of the discussion group for several years but just noticed this new forum. It seemed like a few of you might like to read my story.

I am not and have never have been transgender. There is nothing natural or normal about my need to express myself as my gender not assigned at birth. I have Dissociative Identity Disorder (DID; sometimes referred to as Multiple Personality Disorder/MPD). My innate ability to dissociate enabled me to survive childhood trauma by splitting my mind into me and separate 7-year-old child, bulimic tweenage girl, Protector and Inner Self Helper personalities. It was a highly successful coping mechanism that enabled me to do an amazing job of simulating a healthy person. I have had an amazing life life, got through my first wife's death, retired early after a successful career as a graduate level engineer, have been married to an amazing woman for 20+ years who has stood by my side through all of this. And I never had a clue...

In 2009 an external event triggered System decomposition. I suffered a midlife breakdown and my 13 year old female alter (Virginia) became self-aware. Virginia is strong, fronted for my System through junior high. But so am I; I was System host the other 46 years. The battle between us for control of the body was a bloody one. DID is a disorder of secrecy; the victim's life depended on hiding it. My condition flew under the radar of a full psychological profile and THREE years of therapy with a GT and a cognitive psychologist. The more my doctors insisted I was in denial of my transgenderism, the more I refused to come out or transition. When I began to experience time/memory loss, nightmares and flashback, I was rediagnosed with DID and referred for trauma recovery therapy.

My wife and I are retired and arranged our schedules so Virginia has 2 days a week to live her own life. We do our best to accommodate the occasional things she wants to do with her friends on other days but she is simply not capable of fronting anymore on a regular basis. A few close friends know Virginia and I are DID and there is no controlling triggered shifts between the five personalities in my System. But no one in either of our worlds, even my wife, knows both of us. Virginia has her own ID, credit cards and wardrobe. Unlike my child alter, she is a good driver so she is allowed to come and go as she pleases on the days she fronts. Like any 13 year old, she gets an allowance, is not allowed to drink alcohol and has a curfew. I am tall and skinny so Virginia has never had any problems with people recognizing she is a girl. She's built like a model, can wear virtually anything and looks nice in a modest bikini at the beach. We have lived as separate cisgender people with absolutely no crossover in our lives for over 5 years.

My Child, Protector and inner Self Helper are not narcissistic alters but finding a balance in sharing the body that worked for Virginia and me was a long painful process Virginia's body dysphoria centered on hair. It was the biggest difference between my 50 year old body and the prepubescent one she remembered when she fronted for my System when I was 13.  Settling on wearing my hair in a shoulder length grunge was easy. I have wanted long hair since it was in style when I was a kid and I'm just one more longhaired country boy here in the South. We agreed on laser/electrolysis to remove my facial hair, keeping my Van Dyke because of the importance of facial hair to my sense of self as a man, and reshaping my bushy adult eyebrows so they were more like they were in my grade-school pictures. Our big sticking point was what to shave. My body hair made Virginia dysphoric and shaving my chest underarms and legs made me dysphoric. Fortunately the full transition level estrogen HRT regimen I was given to treat GD reduced my body hair to fine vellum. A year and a half on hormones and I was able to stop shaving my body altogether. Virginia being a tween tomboy rather than a real girly girl made things a lot easier. She is into the whole back to nature, fuzzy underarm and leg, surfer chick thing and the fine vellum hair that covers my chest and legs is important to my sense of self as a man.

We were both extremely worried about growing breasts when I started hormones. At 13, womanly curves are no more a part of Virginia's self image than they are mine. The A cups I developed from HRT turned out to be surprisingly important to her sense of self, and don't keep me from going without a shirt in the summer. But it has taken nearly five years of therapy to understand the psychological relief I get from estrogen has nothing to do with giving my brain the right hormones. The peace came from chemical castration and meeting my need as a trauma victim to end the cycle of abuse once and for all.

An eighth inch of white is a good balance for my nails and Virginia occasionally uses clear polish when she fronts. She agreed to me keeping my Van Dyke so I put up with a French pedicure for her. Trading in my tightie whities for colored mens bikinis and replacing my wardrobe of over-sized cut mens clothes that are in style today with things that are more form fitting like the ones I wore back in the 70's, Virginia is pretty comfortable on the days I front. For her part, she reciprocates by doing the clean natural thing with her makeup and except for the clingy stuff she wears to yoga, stays away from over the top female fashion. My cognitive psychologist was an immense help with learning to share the body. In hindsight, Virginia wasn't really asking for all that much; she just wanted to look like I did back in the 70's when she fronted for the System in junior high. (Scratching head) It seemed like a helluvalot to ask for 5 years ago...

Two years after my breakdown Virignia and I were in a stable enough place for my mind began to explore the things that happened when I was child in flashbacks and nightmares. My wife's therapist, my trauma specialist and cognitive psychologist and our couples psychologist have all told me trauma recovery therapy is the most horrible therapy anyone can go through. They were right. I wouldn't wish what I have gone through the last 2 ½ years on my worst enemy. But the consolation of truth is peace. I have recovered my memories of my near downing and being raped, my parents psychological abuse, the gender confusion in only having girls for playmates and being given my female hand-me me-downs as a child, and the strict delineation in the things men and women were and were not allowed to feel or do. I see my childhood for what it was and I understand with my adult mind the affect it had on me. My marriage not only survived but my wife and I have grown closer than I ever dreamed was possible.

The solitary self does not win when one part gains at another's expense. Catering to one of my alter's needs would have done nothing to fix the underlying cause of my need to express myself as male and female. Transitioning would have cost me my marriage and the life I spent 50 years building; I would be just as unhappy being stuck living as a girl as Virginia was living as a guy; And I would still be battling the demons my child's mind locked away nearly 50 years ago... if I hadn't chose suicide.

Thank you for sharing your story. It's something I've questioned may be going on in my own life (likely just because when I came out as a teenager my mother suggested this was the underlying cause, but mild disassociation and thoughts/feelings that don't seem to make sense have made me wonder), so hearing that if that's what therapy uncovers there is still a chance of peace means a lot too me.

i'm glad that you seem to have found a balance in your life Virginia. I know you've had a very, very rough road getting to this point.

VA, be well and give my regards to Brin.

I sort of have DID too.... I don't officially have it because I lack the dramatic "switching" and time loss needed for a diagnosis but I definetly have a few different people in my head. Kitty my host/person in charge ,the 18 year old girl (our body is only 18) left us abruptly when I went to college a couple months ago. I am jason ,an 18 year old boy. I still share a body with a six year old girl and a twelve year old girl . almost everyone thinks I'm jus a normal FTM and doesn't understand why i'm so afraid to do anything permanent......the truth is it's because I'm worried about upsetting the littles and if kitty comes back......am I actually not trans too?

"Natural born" multiplicity aside, dissociation is a sliding scale and there are a whole host of dissociative disorders, ranging from PTSD to DID.  The correlation is so strong, standard therapy protocol is to assume something very serious happened to a person at a very young age to fragment their mind into separate personalities until it can be established there wasn't. I am a firm believer in the SOC requirement for therapy prior to any sort of transition- even more so for a Multiple. Until you understand the exact nature and reason for your System, changing something as your gender to satisfy an individual alter's needs could be devastating the psyche.

I was sexually and emotionally abused as a child , so I do know why I'm this way....

I just read this in another thread and I am so very very sorry...

Something I realized I failed to mention in my original post (correction made above), is that Virginia is bulimic. Bulimia is a common way young teenagers (more typically girls) who were traumatized before they were 10 attempt to gain a sense of control over their lives. Our couples psychologist picked up on it at one of our first sessions based on my 5'10" 146 pound build. I vehemently denied having an eating disorder, just as I had her suggestions that I had been molested or had anything less than a perfect childhood. I carefully controlled my weight my entire life, a combination of eating like a horse, working like a dog and fasting for health reasons once a week for years. I lived a healthy lifestyle. As my DID continued to manifest itself, Virginia started making herself vomit during flashbacks and thjere was no denying my doctor was right.

I agree that some sort of therapy is a good idea before transitioning. I have seen a couple of people break down during transition or with symptoms that were something else than being trans.
I just want to add that it's possible to be trans and traumatized. And it would be very difficult to established cause and effect in that case.
During the 80s, trauma was always assumed to be the cause for transgender, especially for ftm. There was no difference between that and the older assumption that all lesbians had "bad experiences" with men. Only that now lesbian, "progressive" and feminist therapists applied (and still apply) that theory to trans patients.
People who suffer from DIID, strong dissociation, self harm or intense PTSD need help for that. But it can be turned into a transphobic script if you happen to meet a transphobic (though otherwise "liberal") therapist.
So I'm warning against buying into types of therapy that assume from the start that trauma is the cause for being trans (the therapist won't always tell you head on).
The therapist should be open to the possibility that someone is trans and traumatized at the same time, otherwise they are biased.

Add: Generally speaking, suggesting "repressed memories" is also a problematic practice. A good therapist doesn't suggest anything, but only works with what the client brings into the session.

Interesting flip side to the GT who insisted I needed to transition. And she professes to be not only be experienced with gender but in working with adult survivors of childhood abuse and Dissociative Identity Disorder. It may be the pendulum has just swung too far in the other direction with all the current media attention on transsexualism.

It is certainly inappropriate to assume trauma is always the cause for a person being transgender with as much as we have learned since the 1980's. Given child molestation rates about four times the percentage of the population who are transgender (20% girls/5% boys molested vs 2-5% transgender), it is reasonable for a therapist to begin therapy under the assumption that a patient is suffering from the effects of trauma rather than being transgender- even less likely a person has been traumatized and is transgender. But the correlation between child abuse and DID is so strong, protocol is to treat a person was abused as a child until it can be established they were not.

The distinction between recovered and false memories becomes apparent in DID flashback (the conscious mind simply cannot relive the memory as if it is actually happening the way the subconscious mind can), but a therapist suggesting repressed memories is very poor practice. In my case I was fortunate my Mother is still alive to confirm all of my recovered memories. Taking away the doubt has been extremely validating and has brought me a great sense of acceptance and peace. It is actually kind of creepy how little my trauma recovery therapist speaks in session. Other than asking how something makes me feel or repeating what I have said to affirm it's truth/untruth, she hardly says a word. Our sessions remind me of the old TV series MASH when Sidney the psychologist would visit the 4077.

Binter wrote:
it's possible to be trans and traumatized. And it would be very difficult to established cause and effect in that case.

I don't understand. Transgenderim and trauma are two very different things. Could you please elaborate?

Yeah, I agree that trauma can really confuse the clinical picture.  I haven't yet worked through all of the pieces in my own puzzle, but I can say that it is very complicated and much caution is needed. 

Emotional and sexual trauma, especially at certain vulnerable ages, can effect the normal process of consolidating gender identity in the first place.  In some cases, those with PTSD can have "gender dysphoria" as a symptom because they were never given the chance to fully consolidate their birth gender - and of course, DID can really make things even more complex.  So, in this sense, trauma at certain points in development can really do a number on gender identity & in these cases, "therapy" means working through the trauma and embracing yourself as the gender in which you were born.

But its more complicated-
Some people are, apparently by genetics, trans.  And these people will be trans whether they grow up in the 3rd world or as heirs to a Hollywood movie star.  They are born trans in the same way as someone is born left-handed, it just is what it is.  But our world doesn't really embrace these people and instead punishes them.  So it becomes a chicken / egg question...

Did I start out as young person, say age 4 or 5 and present as a girl when others thought I should be a boy?... and did this make people hurt me?...in other words, did I start off trans and then get traumatized as a punishment for being trans?  In these cases, what is done to a young person CAN be severe enough even to cause DID.  In fact the condition of being trans in and of itself can be severe enough to cause dissociation (how else can some trans kids survive?). 
OR
Did I start off as my birth gender indicates and get traumatized for some other reason but because of what happened it skewered my development and/or caused DID?

As with all areas of therapy and treatment, trauma is an unforgiving wound and complicates everything.  My thoughts and prayers are with you as work towards finding, understanding, accepting and embracing yourself so that you can be the person you need to be.

Thanks for sharing, Virginia.

I also have DID, and am trans. For "us", once the former ("primary") male knew he was...ummm...vacating the post, I became the new primary. He was 47 (also the body's age, although he had only been primary for a handful of years), while I was--and still--28. I've been out for 3 years now.

The only caution I was given, by the TG/TS community as well as my the*apist and those "inside", was to take transition slowly...making sure everyone is onboard with further transition. At first it was nails and hair (growth and removal, depending on location), and now its to the point we are going to complete the physical process next year.

The Others just needed to know that they are safe with us being as we are...and some have started their own transition inside our System.

Love and accept all your Parts/Alters, even the seemingly mean and angry one(s); they're a part of you just as you are and the Out male.

*hugs* if safe, and happy life!

Excellent discussion, Everyone!

I appreciate your example, paxi1334, that makes the idea clear for me. It would certainly be difficult to know which condition preceded the other in the case you describe, even more so if a child experienced non gender related trauma and also happened to be transgender.  it is vital to get to the underlying cause of a person's need to express themselves as their GNAAB; jumping to any conclusions can have devastating effects.

Beth Andrea wrote:
Love and accept all your Parts/Alters, even the seemingly mean and angry one(s); they're a part of you

Tears. Words of wisdom, Beth Andrea. And so painfully hard to do...

Beth Andrea wrote:
At first it was nails and hair (growth and removal, depending on location).

Interestingly these were also the first two things that happened to me. The urges were completely uncontrollable. Within 5 months I was sitting to pee and tucking 24-7, had lost over 30 pounds; quit a 40 year nail biting habit, grown them out to an 1/8" of white and was using clear polish; groomed my eyebrows; started growing out my flattop haircut; begun to develop a female voice; shaved my legs, chest and underarms; and begun laser hair removal of my beard. I was wearing lip gloss foundation, eyeliner, a bra and (masculine styled) women's blouse, slacks and shoes to work, and had been accepted as a women when I went out for the evening to Church and dinner. All sold as a few small changes to satisfy what I then called my "female self." I had no idea what was happening or how far I had gone. Virginia played the same bait and switch game to get her way that my Mother did when I was a child.

QuoteThe urges were completely uncontrollable. Within 5 months I was sitting to pee and tucking 24-7, had lost over 30 pounds; quit a 40 year nail biting habit, grown them out to an 1/8" of white and was using clear polish; groomed my eyebrows; started growing out my flattop haircut; begun to develop a female voice; shaved my legs, chest and underarms; and begun laser hair removal of my beard. I was wearing lip gloss foundation, eyeliner, a bra and (masculine styled) women's blouse, slacks and shoes to work, and had been accepted as a women when I went out for the evening to Church and dinner. All sold as a few small changes to satisfy what I then called my "female self." I had no idea what was happening or how far I had gone. Virginia played the same bait and switch game to get her way that my Mother did when I was a child.

I/we also did these things, except for the shaving legs, chest, and arms (all of them)...well, we shaved the first time, but then went to waxing.

After we got on HRT, waxing became far too physically painful...it had been painful before, but not as much as the emotional pain from experiencing a hairy man-body. HRT reduced the emotional pain to a degree we'd never EVER experienced. Spiro especially reduced the emotional pain...OMG testosterone is a poison to us.

Interesting also, that our former male self often referred to me as his "female self." This was before we realized we were DID. He waited to let me name myself, which I did (Beth, not Elizabeth). He knew prior to my appearance that his time was very short--either suicide or another Alter--and together we worked to get me up to speed about his work and other roles (husband, father, etc). But the Others inside would not have the confidence in me unless I could present an "authentic" appearance. The more we did, the more content (dare I say, "happy"?) the Others became.

For us, there was no bait and switch. There was life--or death. Life meant we must transition. In fact, some of the changes were suggested by the male self; he despised the masculine things in our life which had become too-obviously false to him.

Also, the more femme we presented, the more interaction we had with other humans. It's incredible that on one day we could be "male", and we were invisible to everyone (i.e., no hellos or goodbyes, unless we initiated...and even then, most people simply did not notice we were there at all)...next day we'd be "Beth", and nearly everyone greeted us with hellos and talked freely about all sorts of things. They noticed us, and in a good way.

QuoteThe more my doctors insisted I was in denial of my transgenderism, the more I refused to come out or transition.

This kinda jumped out at me just now when I re-read your first post...is it possible that you are transgender (even though you currently deny it), and you (or your male self) see it as a threat? Hence the refusal and the later "restrictions" on Virginia? (Understandable, considering the "world" you've created--a good one).

Having said that, of course it is your Self/Selves who would have to discuss it in the safety of your own mind, and with your the*apist. It is a given that repression--whether of the male or the female--is a bad thing. So far, it sounds like you've achieved a sort of balance between the two.

It's interesting the male alter of both of our Systems referred to our female alters as "female self." Even though we had not as yet been diagnosed with DID, at some level he and I must have sensed they were not personas of a solitary self.

Like you, Virginia has a much lower tolerance for pain than I do. Handling physical pain is part of my role in my System. Virginia handles psychological pain, my Child alter fear and my Protector rage. I have come to thrive on it from the years of guilt and self punishment, have used my ability quite constructively over my life to push me to my competitive edge. And it makes me the logical choice for host given I live in constant pain from degenerative scoliosis.

Virginia enjoys being around people more than me, but I did too when I was young. That said, most people perceive me to be an extrovert although my preference is to be alone. She and I both prefer a handful of close relationships to being social butterflies. As is generally the case with the contrasting characteristics of alters, people just accept our flipflopping back and forth as an idiosyncrasy without thinking much of it.

Authentic is extremely important to both me and Virginia, a reaction to the "non" authenticity of my parents. But my female alter's personality was so highly developed from the years she spent with other girls as a child and fronting for the System through junior high, being much more coconscious with me than I was of her there was really nothing she needed to do to "get up to speed" so she could front again. A few grooming changes, some clothes, a little makeup, develop her voice, but no learning per se'. I suspect this was the reason she was able to move so rapidly with the things that were important to her when she became self aware. I absolutely understand the need for a slow transition in your case to be certain all of the alters, especially the children, feel safe.

Virginia is and has always been extremely secure about who she is (many thanks to my Mother for instilling both of us with overwhelming self confidence). Although she enjoys expressing her femininity, she is only 13 and makes a game out of fooling people into thinking she is me by stepping in while I am fronting. The androgynous way we keep the body makes it extremely easy for us both to be accepted as the man/woman we are by simply coming to the front. When I am clean shaven I can literally walk into the mens room wearing jeans and a tee shirt, comb my hair differently and when Virginia comes to front on the way out people will see a female.

A few notes about my System:
None of my alters including me (host) are my body age of 54 although I am the oldest at ~30. It seems after my first wife was killed when I was in my late 20's my mind said it just didn't want to get any older...

I mentioned above that Virginia is bulimic. My Child alter rarely talks because he is self conscious of his stuttering. Two wives and 25 years of marriage, I have never been able to bring myself to have intercourse. It's amazing the things we can explain away...

I am extremely trans-homophobic from having been raped by an older boy. Given the fundamental difference in my System being cisgender and yours being transgender, it's easy to understand why our paths began to diverge from here. My Inner Self Helper made sure Virginia and I reached our balance long before it began to reveal to me the things that happened when I was a child. As alters she and I are female/male to fill our rolls in my System- hormones can't affect that. Testosterone is no more poisonous to Virginia than estrogen is to me, of course I happen to be fortunate to be in a body consistent will my identity as an alter. The complete lack of psychological effects and desire to transition I experience having been on a full transition level HRT regimen for almost 5 years now makes no sense from a transgender point of view. From the perspective of reducing Virginia's body dsyphoria by making it more closely resemble the way it was when I was ~13 and chemical castration to meet my System's need as a trauma victim to end the cycle of abuse once and for all, it becomes clear why HRT gave me peace for very different reasons.

Beth Andrea rote:
is it possible that you are transgender (even though you currently deny it), and you (or your male self) see it as a threat? Hence the refusal and the later "restrictions" on Virginia? (Understandable, considering the "world" you've created--a good one).

Just as the transsexual will transition, the System will do what the System must do for the good of the Self. I had no idea when Virginia first became self aware it was not possible, but she certainly threatened to takeover. Five years later I still kid myself that as host that I have some control over my alters, but the reality is I was no more able to restrict Virginia when she first became self-aware (or now) than she is able to restrict me. Decision like that are made at a level above both of our pay grades by my ISH.

My System's need to express itself as female is wholly contained in my female alter. I thrive on being a guy as much as she thrives on being a girl (I hate to keep leaving my other three alters out of this discussion but they just don't have the narcissistic needs to express themselves as we do). My MMPI-II/MCMI-III inventories indicated that I was not only gender dysphoric to a level indicating MTF SRS, but to a level indicating FTM SRS. The changes Virginia needed when she first became self aware were tearing me to shreds. It was even worse when we attempted to find a middle ground with an androgynous appearance. It was just as important to her as it was to me that there was no question in how people saw us; it stood squarely in the face of both of our needs for "authenticity." It was at this point my ISH revealed to us both the best balance was compartmentalization so Virginia could be 100% female as much as she needed and I could be 100% male the rest.

My trauma therapist has observed that between Virginia and I we "almost" make a whole person. The way my mind not only split up feelings but abilities between us, we are each incapable of living without the other. What ultimately made this clear for us both was each of us in turn attempting to take over the body. I made it almost 30 days before I had devolved into a state of complete dissociation. She made it a week before she simply disappeared (My psychologist was FURIOUS at me for attempting this stunt). Virginia is not strong enough to front more than 2 days a week on a regular basis, and she is happy to turn things back over to me, experiencing life coconsciously and occasionally bleeding though if something triggers her the rest of the time. I plod along the other 5 days exactly as I have for the last 54 years.

Virginia made her needs clear to my System before I even started therapy. Five years of a transition level estrogen regimen, therapy, diagnoses of transsexual, androgyne, bigender, PTSD and finally DID; giving Virginia 2 out of 7 days a week to live her life continues to be the balance that meets the needs of the entire System. The Solitary Self does not win when one part gains at another's expense.

"Bunter wrote:
it's possible to be trans and traumatized. And it would be very difficult to established cause and effect in that case.

I don't understand. Transgenderim and trauma are two very different things. Could you please elaborate? "

That's what I meant, too. It would be difficult to know if someone would turn out trans anyways, in cases where the abuse happened early.

A therapist suggesting that someone *needs* to transition is just as problematic as the other way around. Therapists need to stay neutral.

I have a question- how did you know you had DIID? I mean before a diagnosis?

And here is another thought, that a professional therapist once told me in a conversation: What does it matter? If a woman had been raped and now lives only with women, and is happy with her relationships? Would it be ethical to treat her for being a lesbian, because it might have been "caused" by the abuse? Should she be treated to become "normal" again?

QuoteGiven child molestation rates about four times the percentage of the population who are transgender (20% girls/5% boys molested vs 2-5% transgender), it is reasonable for a therapist to begin therapy under the assumption that a patient is suffering from the effects of trauma rather than being transgender- even less likely a person has been traumatized and is transgender.

I'm not sure that makes sense logically- why would anyone present as transgender to a therapist just because they have been abused? What correlation is there?
And if there were a correlation, shouldn't the numbers of presenting mtf be *much* lower than the numbers of ftm?
If a girl wanted to be a boy to be protected from abuse (or whatever the theory is), shouldn't an abused boy prefer to stay a boy for the same reason? Or if the boy was abused by a man, and thus wants to avoid being a man (another such theory) why would the girl want to become "like the abuser" and the boy not?

Added: I agree that when the wish to transition happens very suddenly and out of the blue, and someone pushes through with everything at breakneck speed, that's a warning sign.
Though on the other hand, you never know, and I have seen people with no trans past who transitioned and were super happy afterwards, and very well adjusted. The thing is- we just don't know what transgender is (despite what some people might say, nothing is certain scientifically). It could just be a normal variant that happens spontaneously because of the physically androgynous nature of us all. Some people could even have shifting genders naturally.

Thank you for continuing to share your thoughts and experiences in this thread, Bunter. It is vital for people who are questioning their gender to understand the nuances of the various reasons a person may have a need to express themself as their GNAAB.

You ask several excellent questions and I will do my best to share my perspectives.

Bunter wrote:
how did you know you had DIID? I mean before a diagnosis?

I began to suspect I was DID when I started to experience flashbacks and time/memory loss on the days my female alter fronted. The pieces began fitting together at that point for me and my psychologist (other dissociative behaviors, uncontrollable actions like shaving my body, thinking in different voices, triggered changes in my speech, facial expressions, mannerisms and behavior).

Bunter wrote:
What does it matter? If a woman had been raped and now lives only with women, and is happy....

(I am assuming this was meant for me to consider so I am answering from my perspective)
I see the key word here as "happy." My DID was having a very negative impact on my ability to live my day-to-day life. I was, and still am, very unhappy with the impact having a female alter has on my life.

Bunter wrote:
I'm not sure that makes sense logically- why would anyone present as transgender to a therapist just because they have been abused? What correlation is there?

Not a correlation; I was just pointing out that given the likelihood of other factors that can lead to gender confusion is significantly greater than then likelihood of being transgender, it would be reasonable for a therapist to begin therapy under the assumption that a patient is suffering from the effects of another condition, not that they are transgender (ie. it is more likely you have indigestion than are having a heart attack).

Bunter wrote:
If a girl wanted to be a boy to be protected from abuse (or whatever the theory is), shouldn't an abused boy prefer to stay a boy for the same reason? Or if the boy was abused by a man, and thus wants to avoid being a man (another such theory) why would the girl want to become "like the abuser" and the boy not?

From a DID perspective, it is common for people with MPD/DID to have opposite gender personalities in their systems. Male alters give female trauma victims the strength they do not believe themselves to possess as women. Female alters give men a way to justify in their minds the horror of having been molested and a way to resolve the resulting sexual confusion. I was no exception.

Quoteother factors that can lead to gender confusion

Yeah but that's exactly the point- why should trauma lead to "gender confusion"? And what exactly is meant by "gender confusion"? I don't see there is an established connection between trauma and gender confusion.

You say that the differently gendered alters are the cause for the trans behavior. But isn't multiple personality disorder *extremely* rare? Much more so that being trans? So that the probability that someone is multiple is even rarer that someone being trans?

I've read an article that suggests up to 6% of the population may be DID, but for most of them it isn't a problem. I know before I was diagnosed with it, I would joke with coworkers that I don't take my work home, because the moment I got in my car, I'd forgotten the entire day! The next day I'd  come to work, and did not think at all about problems at home, because work was "the world" for that Alter. And there were other areas and activities that were simply not accessible--or even remembered--unless I was right there doing it.

Trauma could create a TS person by the Self rejecting the body if it's perceived as being the abuser. My first foray into modifying my body was not a need to transition, but simply a way of getting rid of the feeling of being "trapped" inside the abuser's body (he had a hairy chest and it sickened me to have that.)

Nodding knowingly. Thank you for sharing the very personal reasons for your foray into modifying your body, Beth Andrea. It makes complete sense and I can relate from my female alter's wanting to make my body look more like she remembered it being when I was 13. I don't think I will ever quite get over the shock of seeing how amazingly similar the experiences of others with DID is to my own.

I too have seen estimates of upwards of 6% of the population as having DID. Dissociation is a highly effective coping mechanism and many people live out their lives as "healthy multiplicities." My System worked so well I went 48 years before I even became aware of it; my 84-year-old Mother's multiple personalities (at least one is male) enabled her to survive a drunken Father and being molested by her older brother to go on to live a happy productive life.

@ Bunter:
Having different gendered alters could give the appearance of a person being transgender, but in and of itself is not the cause of true transgender behavior. I was using the terminology "gender confusion" as an umbrella term for all of the reasons a person may feel a need to express themself as their GNAAB other than being transgender. I did not mean to limit my comments to DID because of the high occurrence of child molestation.

Trauma, specifically molestation and rape, have devastating effects on a child. The effects are clearly established in the psychological literature. Leonard Shengold's "Soul Murder" is an excellent reference. The actual psychological condition varies depending on whether a child has an innate ability to dissociate, from dissociative disorders on one end to sexual dysfunction, and the gambit of psychotic disorders on the other. Their innocent brains have simply not developed to the point of being able to handle the over stimulation of orgasm; it literally exploding their minds. The child's attempt to understand and rationalize what happened to them can lead to gender confusion. For someone with DID this could be through the function of male/female alters for female/males, respectively, as I described above.

I will note that "our" transition was relatively slow, mainly because I did not want to permanently change the body to fit my self-image; long hair, earrings, and nail polish are not permanent modifications.

Once we began to consider hormones, it was several months with my the*a list and Others to make sure everyone was on board with the effects of hurt (both emotional and physical)

Oh, you should have heard the chaos when we were prescribed testosterone for depression! And the howling when we actually tried it! Obviously no one wanted THAT...but when we tried phyto-E, that made everyone (even the males) very...pleased. After that (and once we were actually on HRT) there's been no disagreement or reluctance to transition. Just the thought brings fits of giggles within.

So yeah, for our System, transitioning is A Good Thing (tm).

Virginia
I am so sorry for you honey. I to know all too well of the physical, mental and sexual abuse as a child. It is an unconscionable thing that these people perpetrate on us. I cannot imagine how hard this is been on you. Although going through this trauma as a child I did not develop a split personality. Nobody knows the hell that we have been through everybody's experiences are different and we cope in different ways. Just by reading this thread has helped me tremendously because I know I'm not alone. The recovery from trauma like this is very long and hard. It's very hard to comprehend why individuals would do this to a child. For longest time I questioned what I did to cause this to happen to me. After years and years of therapy. I did learn that it wasn't me that did anything wrong. It was them, and it's just so hard to imagine than an actual family members would do this to me.

It's simply amazing the way the mind works at protecting ourselves. Although I don't have a split personality,  I was able to block most of the trauma out for a long time. And after a while it just kept coming back, like just when I was getting comfortable. There was this knock at the door and I'd open it and all the trauma would come rushing back at me. There has been attempts at self-mutilation and suicide. Addiction to pain medication was one way that I tried to ease the pain.

Through my cognitive therapist and then my gender therapist, I have come to learn serenity. It's really amazing how the different parts of your system have come together to help you heal and live more happily. I wish you nothing but happiness and joy that you deserve and please give your wife a huge hug for me. She is an amazing person. I'm very impressed with her still standing by your side. After everything you've been through me. The Angels always look upon you and help guide you on your path. Be well and be safe.

Hugs,

Melissa Ann

@ Virginia, I believe that is some cases there might be an etiology like the one you describe, but I have a problem with the sweeping generalizations that you draw from that.

The diagnosis DID is highly controversial http://en.wikipedia.org/wiki/Dissociative_identity_disorder It also seems to be used as an umbrella term that covers different types of dissociative disorders, from forgetfulness, daydreaming up to multiple personality disorder. While milder dissociation is very common, developing alters, or a full fledged multiple system is very rare. The numbers range from 0,01% in the 1980s, up to 1-3% now. It is mainly a US diagnosis that is rarely found in the EU where the prevalence seems to be more 0,01%.

Having multiple alters can still co-exist with being trans. A while ago I talked to a trans man who was diagnosed with actual Multiple Personality Disorder, and who after a longer therapy transitioned. He seems to be very stable now, with less alters than before. His therapist didn't see the disorder as a reason not to transition as long as the whole thing was undertaken very slowly and with a lot of therapy.

"The child's attempt to understand and rationalize what happened to them can lead to gender confusion."
I agree that trauma can cause confusion of all kinds. But I don't share the assumption that the causal route is: straight child gets abused and turns either gay or trans.

For example, there are many cases when a gendervariant or gay child or teen (i.e. someone who had already some self-awareness of being gay or gendervariant) was raped, and after that got highly conflicted about their sexual identity, trying to get rid of the gayness. They often feel guilty, like they have brought about the rape by being gay. Some are trying to become straight by reparative therapy and so on (see for example Peterson Toscanos Blog). Only later they understand that the rape was not cause by them being gay.
Similarly, a young trans child who gets raped might develop a massive problem with their identity and try to become cis.

Why am I writing all this? I want to offer some alternative interpretations to counter the very narrow and moralistic narratives that exist in the US when it comes to LGBT and trauma. When therapists have only that one narrative in their minds to interpret the experiences of LGBT survivors, it can cause massive additional harm. What they do in fact is use the very real trauma that LGBT youth experienced, to cater to their normative narrative "straight cis child gets abused and turns either gay or trans." (and not the other way around).

I know you don't mean it that way, and differentiate between "real" transsexuality and "mistaken" transsexuality. It's just that you can't be sure if it's one or the other only by looking at trauma.

MelissaAnn, I am touched beyond words by your encouragement and sympathy.

@ Bunter
I have not received a reply to the PM I sent to you a week ago (11-7) about your most recent post. I wanted to give you ample time to respond off line, but need to take a minute to clarify a few things you mentioned so I can move on with this.

"there might be an etiology like the one (I) describe."
There is; I am example of it. By the statistics you quote (1-3%), DID is about as "rare" as the percentage of the population that is transgender (2-5%). The SOC requirement for therapy prior to recommending any sort of transition exists because of the high likelihood a person's need to express themself as there GNAAB is the result of a psychological condition rather than them being transgender.

I found the reference to an encyclopedia citation on DID to be deprecating. Stating that "full fledged multiple system is very rare" and referring to someone who was diagnosed with "actual Multiple Personality Disorder" to be extremely demeaning. Dissociative identity disorder is NOT an "umbrella term" that includes daydreaming. It is a serious psychological disorder resulting from severe childhood trauma. It is primarily a US diagnosis because the country uses the DSM-V for psychiatric diagnosis and that is the terminology used to describe the symptomology. The rest of the world uses the ICD-10, which describes a nearly identical symptomology as "Multiple Personality Disorder" (MPD). Much of the controversy over DID centers on false memories and Freud's theories that the mind can only have one personality but many identities.

The human mind's reaction to trauma is extremely predictable, so much so that terrorists and prison guards employ these same psychological techniques to break down those in their control. The correlation between childhood trauma and DID is so strong, it is standard practice to assume a patient with DID has been traumatized until it can be proven they were not. There was no mention in this thread of trauma in and of itself being the "causal route" of a person's gender or sexuality.

Gender and sex are two very different things and the affects childhood trauma can have on each of them are entirely different. You cannot draw conclusions about the influence rape may have on one from the other.

A person with DID having male and female alters has no more to do with their being transgender than trauma does with a person's sexuality or gender. Beth Andrea shared quite openly her experience that multiple alters can co-exist with being transsexual. Transition is not an option for systems of cisgender male and female alters like mine. The solitary Self cannot win when one part of self gains at another's expense.

Both of our experiences clearly show the devastating consequences a therapist who only has one narrative can have on their patient. The internet is flooded with information about "alternative interpretations to counter the very narrow and moralistic narratives that exist in the US when it comes to LGBT and trauma." I posted my thread because of the lack of information about other reasons a person may need to express themselves as their GNAAB. Posting your views in a thread about the misdiagnosis of my DID as transgenderism was cruel, inappropriate and invalidating to my sense of self.

Very interesting thread!!!

For those who are interested in this topic, this was an interesting read also!

https://di.org.au/transgender-multiplicity/

THIS!!!

https://genderanalysis.net/2017/06/depersonalization-in-gender-dysphoria-widespread-and-widely-unrecognized/

By Zinnia Jones!

I'm going to list some descriptions of certain feelings, and I'd like for any trans or gender-questioning readers to think about whether they've felt anything similar to this over the course of their lives.

- A sense of detachment or estrangement from your own thoughts, feelings, or body: "I know I have feelings but I don't feel them"
- Feeling split into two parts, with one going through the motions of participating in the world and one observing quietly: "There is this body that walks around and somebody else just watches"
- Feeling as if you have an "unreal" or absent self: "I have no self"
- Experiencing the world as distant, dreamlike, foggy, lifeless, colorless, artificial, like a picture with no depth, or less than real
- Being absorbed in yourself and experiencing a compulsive self-scrutiny or extreme rumination
- Having an ongoing and coherent dialogue with yourself
- Feeling like a veil or glass wall separates you from the world
- Emotional or physical numbness, such as a feeling of having a head filled with cotton
- Lacking a sense of agency – feeling flat, robotic, dead, or like a "zombie"
- Inability to imagine things
- Being able to think clearly, but feeling as if some essential quality is lacking from your thoughts or experience of the world
- A sense of disconnectedness from life, impeding you from creative and open involvement with the world


"Depersonalization symptoms can also occur in the context of untreated gender dysphoria, yet this is not widely recognized among the public or in most literature on transness and transitioning. Descriptions of depersonalization-like experiences feature prominently in many trans people's recountings of their lives prior to transition, and these symptoms can heavily impact their general quality of life. But with very little attention given to depersonalization as a discrete symptom experienced by many with gender dysphoria, some trans people may struggle to recognize that this could be an indicator of dysphoria, and may not be aware that they could find relief via transitioning."

Thank you for posting these excellent links, PurpleWolf.
There is a tremendous crossover in body dysmorphia, dissociative disorders and trangenderism that MUST be understood to avoid misdiagnosis and ensure EACH patient receives proper treatment.

DID may not be "rare," but how often is it that someone is diagnosed with gender dysphoria, goes through or comes very close to starting a transition, and is then discovered to have had DID the whole time, receives different treatment, and then the gender dysphoria goes away and the person detransitions?

I understand that it happens, but based on everything I've read, the rate of detransition or transition regret is very small, and most of that is due to societal pressure rather than misdiagnosis. Do you actually think that there are a large amount of transgender people who really have DID and should not have transitioned in the first place?

Quote from: Lucca on July 27, 2018, 09:51:32 AM
DID may not be "rare," but how often is it that someone is diagnosed with gender dysphoria, goes through or comes very close to starting a transition, and is then discovered to have had DID the whole time, receives different treatment, and then the gender dysphoria goes away and the person detransitions?

I personally know of several. But transgenderism and DID affect single digit percentages of the population. It's hard to imagine society ever having enough interest in either group to conduct serious studies as there are for cancer, heart disease, etc...

Quote from: Lucca on July 27, 2018, 09:51:32 AMDo you actually think that there are a large amount of transgender people who really have DID and should not have transitioned in the first place?

I do not believe that, Lucca, and it was never a premise of my post although people keep putting those words in my mouth whenever I discuss my experience me. Nothing I have said is applicable to a person who is transgender, whether they have DID or not.
I DO believe there are more people with DID than who are transgender
That it is the norm for people with DID to have opposite gender alters in their systems
And that to the tragic disservice of people with DID, Gender Dysphoria resulting from Transgenderism has become the "Go To" diagnosis for people with a need to express themself as more than one gender.

How do you determine whether someone has DID or whether they are transgender, then? Based on what I've read, DID has very different symptoms than being transgender does, to the extent that I'm not sure how they're being confused. Like, what am I supposed to do to prove that I "really" am transgender and don't have DID? If there were a lot of people whose gender dysphoric symptoms could be treated without transitioning, I'd think we'd either see a much larger range of accepted, working non-transitional treatments for dysphoric people, or we'd see a much higher regret/failure rate for transition. The way you phrase it, saying DID is more common than transgenderism, you make it sound like %50-%60 of people with dysphoria aren't actually transgender, and shouldn't transition, and if they do it will result in a bad outcome. The statistics don't bear that out.

I am going to do my best to address each of your questions, Lucca:

"How do you determine whether someone has DID or whether they are transgender, then? Based on what I've read, DID has very different symptoms than being transgender does, to the extent that I'm not sure how they're being confused."

The short answer is whether transition helps a person's condition rather than hurts it. The difficulty in determining whether someone has DID or whether they are transgender, is that DID is a "disorder of secrecy." Victims had to hide what they were doing from their perpetrator. As such DID masks itself as a variety of physical/physiological disorders or a persons feelings and memory of their abuse may be contained in one of their alters. Sometimes an opposite gender alters need to express themself can be so strong they will insist they are transgender.

Transsexuality shares many symptoms with DID and other trauma related disorders resulting from sexual abuse. Transsexuals also experience gender dypshoria, sexual confusion and the feeling of having been born in the wrong body for as long as they can remember. They were bullied and did not fit in with other children who were the same assigned at birth gender. Transsexuals often struggle with the idea they are transsexual, are survivors of childhood sexual and psychological abuse, and suffer from the very same psychological conditions DID uses to mask itself (depression, PTSD, bipolar disorder and schizophrenia). Transsexual people can even have Dissociative Identity Disorder. My female alter, Flytrap, started a thread for people who are DID with opposite gender alters (both transgender and cisgender) at: https://www.susans.org/forums/index.php/topic,218553.0.html

It can take years of therapy for a person to "slip" or feel "safe" enough to let down the wall enough that it becomes apparent they have DID (average time a person is in the medical system before receiving a diagnosis of DID is 10 years). In my case I was in therapy 2 1/2 years before the time/memory loss, night terrors and flashbacks associated with DID began. That was the missing link that made it clear to my Psychologist my female alter's need to express herself had been misdiagnosed as transgender Gender Dysphoria.


"The way you phrase it, saying DID is more common than transgenderism...The statistics don't bear that out."
Actually, they do. 1% to 3% of the population have Dissociative Identity Disorder according to The International Society for the Study of Trauma and Dissociation. About the same as the number of people who are gay/bisexual.
http://www.isst-d.org/downloads/guidelines_revised2011.pdf

Only 0.6% were estimated to be transgender in the Williams Institute's landmark 2016 study.
http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf

"you make it sound like %50-%60 of people with dysphoria aren't actually transgender, and shouldn't transition, and if they do it will result in a bad outcome."
Sadly people jump to this conclusion but they are not my words. The purpose of this and all my posts is to make people aware there are other reason besides being transgender they may need to express themself as another gender. NOT to invalidate anyone's transgender identity.

"If there were a lot of people whose gender dysphoric symptoms could be treated without transitioning, I'd think we'd either see a much larger range of accepted, working non-transitional treatments for dysphoric people, or we'd see a much higher regret/failure rate for transition."
The stigmas associated with having a mental illness are strong. The transgender community fought hard to make it clear that GD, not transsexual, is a disorder. Unfortunately this is not the case with DID. The only effective option at this time is therapy combined with psychotic medications. I suspect the rates of failed transition/transition regret are low not because of transition, but because the required screening therapy prior to transition prevents many people for whom transition is not right from transitioning in the first place.

Our couple's psychologist explained to my wife and me her biggest red flag I had experienced childhood abuse was my insistence on how perfect my childhood was. When the time/memory loss, night terror and flashbacks began, it became clear I had developed DID because of this abuse. My greatest concern through it all has been my Gender Therapist's insistence I was a transsexual in denial and her relentless encouragement that I transition, when I was CLEAR, from day one, that as right as it felt to express myself as a woman, it felt equally WRONG. I am 100% unmistakable cisgender male, would NEVER want it to be any other way. How could it not have seemed odd that there was no learning curve for me to be woman? That I had absolutely NO problems fitting into society as a woman and people saw me as a woman the first time my female alter walked out the door... a  year before I even started hormones?

You've quoted statistics about how common DID and transgenderism are compared to each other, but haven't yet provided evidence on how common a misdiagnosis of being transgender and subsequent later diagnosis of DID is. You've suggested that there's a problem with over diagnosing transgenderism when it should have been diagnosed as DID, but then say that the reason that the regret rate for transition is so low that most people with DID instead of transgenderism have it detected before they transition, in which case there shouldn't be a problem.

Perhaps most importantly, in what way do you actually want this to effect the transgender community? Am I supposed to go through 10 years of therapy to prove I don't have DID before having any transgender treatments approved?

Again, regardless of how common DID is in relation to transgenderism, the regret/failure/detransition rate for transition is very low, and most of the regret that does exist is more about societal bullying than being wrong about being transgender. It's an effective treatment for people who report symptoms of gender dysphoria. I'm sorry you had a bad experience personally, but I don't see any evidence that there's anything wrong with the current treatment plan, by and large.


EDIT: Oh, also, you cut out a huge part of the quote where I start with "The way you phrase it", and stuck it somewhere else. That completely changes what I actually said.

Erm, Lucca... I think Virginia is just speaking of his own experience and he has the right to speak about it. He is not trying to undermine anyone else's here.

How is it only his personal experience when he's suggesting significant changes in how we diagnose people?

Nothing I have said applies to the transgender community, Lucca.

It would be up to your therapist to determine if and when any transgender treatments were approved to treat your condition. In my case I was given a letter to begin a full transition level HRT regimen 3 months after I started therapy. Hormones were a Godsend but it drove my GT crazy they didn't send me down the mountain on a toboggan wanting to transition. She never could comprehend it had nothing to do with giving my brain the right chemicals. The peace came from chemical castration and meeting my need as a trauma victim to know I could never hurt anyone the way my parents hurt me. 

It's hard for a person to see anything wrong with the current treatment plan when it doesn't negatively impacted them. If I could hope for some effect from my posts, it would be to enlighten people with a need to express themself as another gender that there are other reasons for this besides being transgender.

If I could bring some emotional clarity from a personal perspective: Or "why this is important to me.".

I joined "susans.org" about 18 months ago, as I had intense feelings of being born in the wrong body. To all intents and purposes I had Gender Dysphoria. Therefore I made the incorrect self diagnosis that I MUST be transsexual. This feeling was so strong that I even came out to my wife of 25 years - The single hardest thing I have ever done. At that point in my life I thought the only way forward was to transition.
Due to medical issues, I did not pursue therapy straight away (too long to go into, but important to wait until they were cleared up first) but I did investigate my GD and posting and reading on here was one of the sources of my information.
I started to realise that that "MY Experience" of GD was not really similar to the majority of the people posting. It had the same symptoms, intensity and pain - but something did not gel. You see, I had a strong "other" my male side who was scared stiff of transistioning, did not feel GD and just wanted to stop these feelings. If at this point I had seen a therapist or psychiatrist and they said I was transsexual then I had no other explanation and would have no other option but to pursue this route to see if it was the answer.
So, out of desperation I wrote a post on here, explaining how I had this duality of experience and no "past-experience" that is when someone kindly pointed out that there may be another explanation. An explanation that I had not ever considered, that I was actually mentally ill.
Exploring DID symptoms and it's causes, it became almost obvious to me that this was actually a better fit than being transsexual. It explained why my experiences did not align with others on here. When I talked with my wife, and said I may be multiple, she just looked at me and said, "well yes honey, I know they are different people I have been living with them for years"!
My point is, I am not transsexual, but the overriding impetus at the time in my head was that this was the only explanation. That my experience of transsexuality was different to the "norm" did not matter as I had little in the way of alternative.
Now, this is where it starts to get dangerous. I met with a psychiatrist - explained the people inside my head. How one is only female, the other male etc etc. He nodded sagely and agreed that I might be dissociative. However, his boss the head of our mental health services did not agree. He arranged a meeting with me, told me straight off the bat that "You are not a dissociative, what you describe is a transsexual in denial". He went on to explain that he had never met anyone disassociated and to be that way would require a very, very specific set of circumstances and criteria that I just did not meet. He strongly suggested that I take gender therapy. Not once, but for over an hour of the meeting. At least a dozen times he said "so, gender therapy, good idea? yes?". It was only on the prompt of a question when he asked me "how does it feel when I dress up female,", that things turned around. I had (and have) no idea how my female part "feels" when she dresses. I can remember her dressing, but for how she feels? I only have her notes.
I remember clearly the psychiatrist stopping dead in his tracks at this response. That is not the response of a MTF in denial.
We then went on to explore my childhood - I was adamant that there was no childhood abuse, however I did know that my female had some visions. Some vile, disgusting visions of a young boy being sexually abused. I did not want to share these, I have no connection to them. The product of a sick mind, I kept telling myself. The P questioned further - what does Sarah think about your childhood? Not being able to answer for her, and the only real reference to my childhood being these visions written down for me, I relented and shared. At that point the P changed tack, the pre-requisites for DID had been demonstrated in part. So my therapy was scheduled for trauma and not gender.

The fact is I do not know what my gender or sexuality is. I have not been a single person for the majority of my life. There is no way I could make a choice on what or how to transition. It would be akin to tossing a coin. The really scary fact is had I not been in a position to challenge, to say his initial theory of me was wrong in the first instance I would now be transitioning.

The fact that so few people regret their transition makes me believe that people like me are rare in society. But, even if one person goes through with a transition when they actually need another treatment, is like giving a lung cancer patient a replacement liver - pointless waste of time and damaging to the individual concerned.
It may be disingenuous of me to also point out that a surgically transitioning individual makes the medical establishment more money more quickly than someone requiring trauma therapy - there is not a financial impetus to diagnose DID. Though, of course that is straying into unethical practices and not somewhere there is any evidence for - but money motivates.

I came to susans looking for answers, looking at how I needed to deal with my gender dysphoria. Without people like virginia on here, keeping an eye out for "outliers" like me, I would have a different future and probably not a very long one. I understand the frustration within the general trans* community with conditions like this, but when your community is the first place people like me go to for help it is only human to be able to provide that support, love and direction. I, for one owe my life to the help I got here.

Quote from: SoupSarah on July 27, 2018, 06:44:25 PM
Now, this is where it starts to get dangerous. I met with a psychiatrist - explained the people inside my head. How one is only female, the other male etc etc. He nodded sagely and agreed that I might be dissociative. However, his boss the head of our mental health services did not agree. He arranged a meeting with me, told me straight off the bat that "You are not a dissociative, what you describe is a transsexual in denial". He went on to explain that he had never met anyone disassociated and to be that way would require a very, very specific set of circumstances and criteria that I just did not meet. He strongly suggested that I take gender therapy. Not once, but for over an hour of the meeting. At least a dozen times he said "so, gender therapy, good idea? yes?".

OMG..... :o!!! That is indeed scary...! Malpractice for sure.....!

Thank you for your post!!! It was excellent!

Ok, see, that's a very clear explanation of why you have DID and aren't transgender, and it delves into diagnostic criteria that seperate DID from transgenderism. That's what I haven't seen from Virginia so far, with him mostly quoting statistics about how DID is more common and making vague statements about how therapists need to change how they diagnose people, without being more specific. If he had explained exactly what it is that seperates transgender people from those suffering from DID and what medical professionals can do determine which it is, then I might not have such a problem with it. Instead, it just sounds like he's saying basic symptoms of being transgender can be DID instead, so therapists and psychiatrists should be putting more roadblocks in our way.

As it stands, sure, if someone displays signs of memory blocks or placing cross-gender feelings into entirely seperate identities, then yeah, that's probably grounds for a DID diagnosis rather than gender transition. That's a pretty obvious difference that should be able to be detected in a few sessions, as it ultimately was in your case.

You are not seeing the point, Lucca. SoupSarah's DID was NEVER "detected." It took their unwavering resistance to their physiologist's insistence that they were transgender to get their doctor to revise his misdiagnosis.

SoupSarah writes:
"The really scary fact is had I not been in a position to challenge, to say his initial theory of me was wrong in the first instance I would now be transitioning."

This scenario is exactly why it is vital for people with a need to express themself as another gender to understand there are other reasons for this besides being transgender.

I think I am starting to see a pattern here. When you get a diagnosis of "transsexual in denial" it's an indication that something more might be going on. The non binary often come here without being sure where they fit in but they are fully aware of the conflict from both sides and they aren't denying the fact that they are transgender.

I attempted to search for "transsexual in denial" and I really couldn't find a good definition for it. It's almost as if it's something the doctors made up when they didn't have a good explanation for what they were seeing in a patient. It would be helpful if we had a few more terms like this that would flag us that things may not be all they seem to be.

Brilliant observation, Dena!

You're still being unclear on what exactly it is that qualifies someone for DID diagnosis over a transgender diagnosis, and also haven't provided any evidence as to what the rate of misdiagnosis is, even though you've insinuated it must be high because there are more people with gender dysphoric DID than there are transgender people, which suggests that the majority of people who go to a therapist and report gender dysphoria aren't transgender, and therefore should not transition, which goes against the established fact that transition has a very high success rate of relieving gender dysphoric symptoms. Those are very important things to clarify if you want therapists to revise their diagnostic crieteria, and I'm not sure why you keep avoiding them. Frankly, I don't want anyone delaying my transition because they think I might have DID just because I have gender dysphoria.

I am ending my conversation with you, Lucca.

Seriously, what did I miss? Because while I don't think you're doing it on purpose, you haven't actually answered most of my questions and have acted like I'm just trying to be difficult. If you don't want to keep talking to me, I'll accept an explanation from a moderator.

All I want is some sort of explanation of how this isn't something that a bad therapist would use against me, and a clear explanation of diagnostic differences from transgenderism would solve that. I want to be properly treated too, and it's not like it's a cakewalk to find a therapist who will diagnose and treat transgenderism properly. Or anything properly if you're even slightly out of the ordinary, for that matter. I've had therapists laugh my problems off because I'm an atheist and they didn't believe that religion could cause someone to be depressed, for example. I'm only concerned about this because the mental health community has put roadblock after roadblock in front of properly recognizing me, not to mention all the unflattering pseudo-scientific explanations my conservative community has tossed at me for my behavior. All I want is the smallest explanation of how this isn't another misdiagnosis someone could throw at my face. You claim to understand that, so I'm not sure why you're refusing to talk or answer my questions.

Hi Lucca,
I think you make some valid points and ask some important questions. They are not easy to answer quickly but if you don't mind I will try to answer some of your questions and concerns. Please understand I am no expert, just my take on the whole thing. I will try and be as precise as I can with my wording but forgive me if I err.

As for "how is it something a bad therapist could use against someone who is genuinely transsexual?"
To obtain a diagnosis of DID is very difficult, most people spend around 8 years in mental health care before getting such a diagnosis. A portion of therapist even refute its existence. That cannot be said about transsexualism, it is a widely accepted state of being enshrined in law in a lot of countries. Of the dozen or so DID individuals I have had the pleasure to talk to, and the hundreds of trans* people, I have heard of 6 cases (including my own) of misdiagnosis of transsexualism and none of the other way round. Of the dozen people with DID I have talked to all but one had alternate gendered parts.
So, this is not something that would affect you. In the UK there is now legislation in place to protect trans* individuals, to give them rights to therapy where as half the psychologist disregard DID as even being a thing.

What qualifies a DID diagnosis over a transgender diagnosis?
And there in you answer your own question. If I am correct, the "diagnosis" criteria for being trans* is believing yourself to be trans? There is no test, no psychological rigour to conform to, your the gender your brain tells you. As a female part in a male body there is no difference between me and a transwoman. I fully believe myself to be female and want nothing more than to live an authentic life in an authentic body. It is only because I realised quickly that I actually share this body, that I know I would hurt my other part in trying to achieve this. Being multiple is not as overt as the media makes out. We don't all of a sudden start using different voices or live in a vacuum from our other parts. When the psychologist was offering us gender therapy, hormones and eventual surgeries I wanted to say "Yes please". A few months earlier and I would of, it was only due to our own research, our own findings, our own perseverance that I was informed enough to understand "that was not me".
So what qualifies? nothing qualifies and it cant be qualified. The only way is to go through therapy, with a therapist who is aware of the issues. I was lucky, my male side is persistent and questioning. He would freely admit to being a obsessive compulsive nerd - not everyone is like that. Some sort of protection needs to be in place. Not so much "I don't want anyone delaying my transition because they think I might have DID" as "I am glad all the checks and balances were in place, it would be horrendous if someone had made a mistake".

Of the five DID people I know of that had an trans-gender diagnosis originally, the length of time was 2-5 years before the gender therapy became derailed. That is a big chunk of someones life and some big changes they accommodated in their life from a mis-diagnosis. All of them were over the age of 30 and all had questions over their true gender identity. By contrast I am very good friends with a bi-gendered individual, they live their life as two separate binary genders. They are resolute in understanding and knowing who they are and how much they need to transition. They know they are two genders. I. on the other hand, went for a long period of time just believing I was the only one in this body. There is no simple test, no one-shot lets anyone decide yes or no. People are not as black and white as that, and DID is a mechanism to allow parts to hide completely within the subconscious. As I said, I did not know I was any different to any other transwoman out there except by talking to people who are trans I started to realise that I did not quite fit. That is a bit of a small hunch to work on and probably not too different from just normal reasonable doubt.

I am not sure but 3% of the population to be DID seems a bit high - I could quite believe 3% of people experience some form of dissociation on a clinical scale, but full multiple personality is not common. My psychiatrist said I was a "Once in a career patient" and has never seen or treated anyone with DID before. Now, that could be because he has never believed it existed and hundreds of DID people have passed before him. We are misdiagnosed with a lot more than just transsexualism. Schizophrenia, BPD, Bipolar and depressives are just a few of the more common ones.

The real point is that DID needs to be better educated amongst all mental health professionals. It needs to be seen and recognised as a probable cause for some other symptoms that are easily misdiagnosed. It is certainly not a call to arms to debase anyone else who is transsexual. But to put it into context, if you were facing major surgery and there was a slight chance that taking a pill for a few months could actually negate the need for surgery, would it not be ethical for your doctors to at least try the pill first?

"What it is that seperates transgender people from those suffering from DID "
As I explained, on the surface there could be nothing - dig a little deeper and you will find they are as different as ham and eggs. The fact is it is not simple. People are not that simple. Trained therapist are the only answer, people that understand the many reasons (not just DID) why someone may express another gender to the one they are born as.

I hope that helps clarify - if you need anything else, then just ask. xx Sarah

Dena, good call about the "Transgender in denial". But if you take it on face value, I am a 47 year old male, with a wife and family. The disruption to all of our lives would be huge to admit to being trans-gendered. It could be that I had lived my whole life as a lie, and it just got too much for me and the only way forward was to make up my multiple parts to justify it to the rest of the world. I am sure it happens. That is why the question the psychiatrist asked "How do you feel when you dress in women's clothes" was so pertinent. Not being able to answer showed us both clearly (me and the psychiatrist) that denial was not the reason. Anyone but a multiple would be able to answer that.

Thank you, that makes it all much more clear :).

Quote from: SoupSarah on July 28, 2018, 12:19:16 AM
But to put it into context, if you were facing major surgery and there was a slight chance that taking a pill for a few months could actually negate the need for surgery, would it not be ethical for your doctors to at least try the pill first?

Depends on the context... has my doctor noticed other symptoms that make him believe that the pill will not only work, but that the surgery wouldn't actually help at all? Or is he just making me take the pill because he requires everyone to take the pill first?

What I want to avoid is having my therapist treat my gender dysphoria with treatments for DID by default, simply on the basis that I have gender dysphoria, or have started to take an active interest in feminine things. That just sounds like the therapist is pathologizing my habit of buying women's clothing to try on, which is the kind of thing that conversion therapy advocates do; slapping people in the face for harmless cross-gender activities and discouraging them from doing them. If the therapist is instead looking for additional symptoms of DID besides just gender dysphoria, and has found them, then yes, treating someone for DID instead of assuming that transition is the best solution would be the way to go. It certainly sounds like you fit the bill yourself, and have an assortment of symptoms that aren't common to transgenderism alone.

As for how easy it is to receive recognition and treatment for being transgender... well, I'm sure it's easier than being diagnosed with DID, but I've personally had the hardest time getting mental health help for even the simplest, most obvious mental illnesses or conditions, and for the silliest, most easily avoidable reasons. Like I said, I had two different therapists refuse to treat my depression just because my stressors were religion-based. I had another one tell me I probably had an autism-spectrum disorder, even though she said in the same breath that she was not qualified to give such a diagnosis, and had not ran me through any official tests to detect such a thing, but that I didn't need one because her personal assessment was good enough. I had a different one who dumped me after two sessions and canceled our next scheduled session saying she wasn't able to help me, but didn't say why, and didn't offer me a referral. I had another one who strongly believed I was transgender based on what I told her (which I now believe I am), but was so pushy about it at a time when I was suffering from extreme anxiety that I got fed up with it and refused to further consider that I was transgender at the time, which set me back months of personal development while I was actively trying to explore my issues and get treatment for them. If she hadn't been so hell-bent on suggesting that gender dysphoria was the cause of all my problems and I needed to transition as the first line of defense against all of them, instead of letting me figure things out for myself, I would've had an easier time accepting everything. Additionally, I know plenty of anti-LGBT religious people who would love to have an excuse to label all transgender people as mentally ill and remove their access to transitional care, which is why it is very important that distinctions are clearly made between the small number of cases where gender dysphoria is a symptom of mental illness which can be solved through non-transitional means and transition might be detrimental to the patient, and the majority of cases where it is best solved through transition. If this is not made clear, we get people like Walt Heyer ruining things for everybody.


So just to make it clear, making vague claims about how gender dysphoria can be caused by a mental illness and be treated without transition is the sort of badgering that transgender people get all the time, and they are naturally going to be disinclined to be receptive to it. Making even a small amount of clarification goes a long way toward eliminating that, which you have done and Virginia has not. I'm not trying to be antagonistic and I certainly did not start this discussion with anything other than simple curiosity, but I've gotten frustrated with the lack of simple answers to my simple questions, and getting vaguely insulting replies that don't address my concerns instead, combined with statistics that don't actually support the writer's point.

For reference, The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides the following criteria to diagnose Dissociative Identity Disorder:
1.   Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
2.   Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.
3.   The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.
4.   The disturbance is not part of normal cultural or religious practices.
5.   The symptoms can not be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).
https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder#1

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides for one overarching diagnosis of gender dysphoria with separate specific criteria for children and for adolescents and adults.
In adolescents and adults gender dysphoria diagnosis involves a difference between one's experienced/expressed gender and assigned gender, and significant distress or problems functioning. It lasts at least six months and is shown by at least two of the following:
1.   A marked incongruence between one's experienced/expressed gender and primary and/or secondary sex characteristics
2.   A strong desire to be rid of one's primary and/or secondary sex characteristics
3.   A strong desire for the primary and/or secondary sex characteristics of the other gender
4.   A strong desire to be of the other gender
5.   A strong desire to be treated as the other gender
6.   A strong conviction that one has the typical feelings and reactions of the other gender
https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria

Lucca

QuoteI'm not trying to be antagonistic and I certainly did not start this discussion with anything other than simple curiosity, but I've gotten frustrated with the lack of simple answers to my simple questions, and getting vaguely insulting replies that don't address my concerns

Your simple questions are not "simple" questions. The simple answers you ask for do not exist. This is not a simple topic and not one best conducted through a limited medium such as a forum in the detail you seem to require.
Your concerns about being misdiagnosed as DID are absurd. I have explained in numerous ways the issue is people with DID being misdiagnosed not the other way round. The fear and intolerance you show about misdiagnosis is held in just the same way by DID individuals being incorrectly labelled. An individual regardless what "slings and arrows of outrageous fortune" they have to contend with should have the basic human right to a correct path for treatment.

QuoteI want to avoid having my therapist treat my gender dysphoria with treatments for DID by default

That  is quite simply never going to be an issue - That is the exact issue the nice people on here have been trying to explain. IF you are DID you are highly likely to be diagnosed as trans. No one is saying IF you are trans your more likely to be diagnosed DID.

If (as I said) DID was better understood and accepted in the mental health community and society at large then your fear about all trans* people being labelled as mentally ill would fall by the wayside. To be able to clearly state that within the mental assessment for confirming trans status that all "mental illness" has been ruled out would leave the community at large free from such persecution - that is why it baffles me that such hatred and scorn is fired at individuals for suggesting it. The essence is it is not the trans* community that suffers but the few? individuals who are DID and enter this community as their first point of understanding. By weedling out the mentally ill, you and your fellow trans* members can clearly demonstrate not only due dilligence in the care of others, but that the people on the pathway to correct their birth defects are sane, whole and completely justified in demanding their care and place in society. In one swoop it stops the extremist views about mental illness being a cause of any gender incongruity. It may also save a few lives.

I am far from anti-trans*. Having been there at the gateway to transition, having made those "coming out" speeches to my closest family - I have felt it, understood the pain and difficulty society places on this community. I do not think "I have dodged a bullet", far from it, I thought I was just naturally female and in a male body. My GD is crippling, I cry for days on end in emotional agony. However, it now turns out that I do not have a clear path forward, that I am mentally ill. It turns out that my issues stem from repeated sexual abuse that happened to me before the age of 3. I am looking at years and years of therapy, painful traumatic therapy. My happy ever after is decades in the future, not a few years of hormone therapy and maybe some confirming surgery. It is also a future of darkness and pain as me and my family cope with me dealing with my years of abuse. This is not required because it is something I am, something I feel - this is required because someone else abused me and used me when I was little more than an infant.

In all of my communication with you I have tried to show you compassion and understanding. I believe for you to move on with this you need to do the same. Trans* people face difficulties, huge major difficulties in health care and society. Being diagnosed as DID is not one of those difficulties as that never happens. There in is the whole point your missing, DID survivors are not diagnosed and instead left to continue along a track that is in most cases harmful to them. The simple raising of awareness of this issue helps everyone involved. Attacking and criticising the issue is just detrimental and fuels the extremist views.

I wish you luck with your transition and  truly pray you get the correct help you need to live a long and fruitful life.

Can we all be friends now? ;)

Sarah xx

nb: in the hour it has taken me to write just this reply, I noticed there has been another post, I have so far not read it so cannot comment on anything about it yet.

What, are you holding me in contempt just because I asked for an explanation? How are you going to gain acceptance by doing that?

I'd been satisfied with your answers up to this point, as I've tried to make clear. What I've not been satisfied with are Virginia's evasive responses as well as his quote-mining, nor your new insinuation that I'm being "absurd" and filled with "hatred and scorn" just for asking for clarification on a topic that I'm not already knowledgeable about, and that I can only learn about by asking questions. I don't like how I'm being treated here, I'd like a moderator to review this thread and if they think I'm out of line, I'll defer to them.

All I wanted was an explanation of what differentiates DID from transgenderism, and how a psychiatrist would distinguish one from the other in a diagnosis. I initially was not given such a thing, was then derided for asking for it, and am now being derided for having received it. Great. I've learned nothing except to avoid the topic at all costs.

Lucca, Virginia is offering the best possible explanation one can offer from the position of having DID. The transgender diagnosis was forced incorrectly by the therapist and it became a matter of digging out the truth. Virginia is here to watch for others who might fall into this trap. It has happened to another member of the site who was able to receive surgery only to discover the mistaken diagnosis. Remember that the opening post isn't so much about being transgender but is about having DID and being misdiagnosed with transsexualism.

Quote from: Lucca on July 28, 2018, 10:44:53 AM
All I wanted was an explanation of what differentiates DID from transgenderism, and how a psychiatrist would distinguish one from the other in a diagnosis. I initially was not given such a thing, was then derided for asking for it, and am now being derided for having received it. Great. I've learned nothing except to avoid the topic at all costs.

If you have a skilled therapist, you state your transgender and you exhibit the symptoms of being transgender, the therapist will have few options other than to diagnosis you as transgender. Transgenderism is a self diagnosed condition so the therapist's purpose is to verify what your saying and determine that there are no other conditions that would interfere with your judgement. The therapist isn't there to diagnosis you though they might make suggestions for you to consider.

DID is another matter because often people who suffer from it aren't aware that they have it. They have gaps in their memory much like you do when you sleep or they might remember the actions of their alter as a dream. The reason they don't realize this is abnormal is because it's all they have ever known so they are unaware of what everybody else experiences. There is an element of self denial when somebody describes an action they took that they lack the memory of.

A good therapist is unlikely to diagnosis you as DID unless a symptom indicates the possibility. This is a relatively rare condition and even when a therapist suspects it, they will have to do a good deal more digging for supporting evidence. The therapist is looking for anything that might affect your judgement and bipolar or schizophrenia are more likely possibilities than DID.

If you should ever disagree with a diagnosis you receive from your therapist, demand the reasons for the diagnosis. If you feel the therapist is wrong, you have the option of discussing it here or seeing another therapist for a second opinion. If a therapist isn't a good fit, there is no reason why you should stay with them.

:police: Also remember that I am watching this thread and the inability to answer a question isn't a reason to be upset. Try waiting for somebody else to answer the question or try to rephrase the question. Sometimes there isn't an answer to a question so forcing the issue isn't going to provide an answer.   :police:

Ah... ok, well, sorry for derailing the thread I was just curious initially, I didn't want there to be any fighting  :(. I probably just shouldn't have said anything in the first place.

This is an interesting topic, think I may follow along as well

Related thread specifically addressing transgenderism and dissociation:
"Dissociation as a coping mechanism"
https://www.susans.org/forums/index.php/topic,239653.0.html

Hello Virginia,

thank you very much for sharing your story and information about DID/MPD.

I had gender therapy many years ago and i was very fast diagnosed by my gender therapist as mtf transsexual.
When she asked me about sexual abuse i had no memory about sexual abuse then. When i asked my brother whether there was any abuse, he was quite astonished and he asked me whether i have forgotten everything? 

Then i had memory flashes, bad dreams and a very hard time and stopped then therapy because everything was too much.

Now, years later i try to get gender therapy again and to continue transition. Your Information helped me to consider the abuse that happened as a possible cause or influence for my gender dysphoria. I will consider this in my therapy. Thank you!

Angelats

THANK YOU for sharing this with me, angelats.
I feel like a fifth wheel on the forum, the voice in the wind no one wants to hear. To know my story relates with you...means more to me than you can know.

Regardless of where therapy takes you, it is vital to find your peace with the trauma you experienced as a child. Transgenderism is a biological condition not a mental disorder. But sexual fantasies about becoming women, a need to dress as women, extreme guilt related to masturbation, gender confusion, sexual confusion, and/or dysphoria about their genitals are all quite common in cisgender males who were sexually abused as children. One in Six men are sexually abused so it is much more common reason for these symptoms than transgenderism. The mind's ability to protect us from things too painful to remember makes it extremely difficult to determine the underlying cause- particularly for a transgender person child with a history of child abuse. Therapy is vital to determine the underlying reason.

My mom just asked me if I was sexually abused as a child because I'm transitioning male to female. This caught me off guard though it had crossed my mind. But to my knowledge I never was abused in anyway, and I was in therapy for a year or two before transitioning. I was in therapy before even crossdressing... The depression and anxiety was only getting worse over time. So my mom asking this makes me realize I'm in this by myself and as we talk more and more, it's pretty clear.

I can understand that your experience of sexual abuse and trauma has influenced your gender questioning. I'd being dishonest if I didn't acknowledge that it does make things more complicated in my situation. Sometimes I think I'd truly be better of dead than having to be constantly questioned and maybe ridiculed. My mom said she wishes she was dead and never saw me transitioning. She's questioning her parenting I guess right now. This is why I haven't been open about things. It's a tough place to be in right now

Sent from my VS501 using Tapatalk

Quote from: Allison S on September 08, 2018, 09:45:59 AM
My mom just asked me if I was sexually abused as a child because I'm transitioning male to female. This caught me off guard though it had crossed my mind. But to my knowledge I never was abused in anyway, and I was in therapy for a year or two before transitioning. I was in therapy before even crossdressing... The depression and anxiety was only getting worse over time. So my mom asking this makes me realize I'm in this by myself and as we talk more and more, it's pretty clear.

I can understand that your experience of sexual abuse and trauma has influenced your gender questioning. I'd being dishonest if I didn't acknowledge that it does make things more complicated in my situation. Sometimes I think I'd truly be better of dead than having to be constantly questioned and maybe ridiculed. My mom said she wishes she was dead and never saw me transitioning. She's questioning her parenting I guess right now. This is why I haven't been open about things. It's a tough place to be in right now

Sent from my VS501 using Tapatalk

It is very important to weigh out everything no doubt. But truth be told it seems like your mom is making your transition about her. Litterly all about her.

Quote from: SailorMars1994 on September 08, 2018, 01:54:29 PM
It is very important to weigh out everything no doubt. But truth be told it seems like your mom is making your transition about her. Litterly all about her.

I'm used to her antics. I just listen and then do what I want. My sisters and brother would agree with you too. She's hard to get along with.

Sent from my VS501 using Tapatalk

I am hoping I would be posting correctly here as there seems to be different areas for ftm and mtf and I am the mother of a young adult whom transitioned when he (ftm) was around 12. My son has been very open about a lot of some of these same topics with us from the time he asked to talk to us. The difference between gender dysphoria and other possible ptsd related diagnoses' are pretty distinct; even from talking to my son. He stated a shame for his body at an early age, a feeling of being male and even of the preference in gender he is attracted to stemming first from feeling possibly lesbian to being assured he was/is transgender. DID should be obvious to any decently trained psychiatrist as the personalities differ rather then one personality and not all altars are present at once. If even more then one altar or personality presents in the course of a session, this is obviously not a case of gender dysphoria. Also, I can only imagine from college studies we did on DID personality disorder, that this is most definitely largely caused by trauma. DID has been heavily studied and diagnosed from the 60's on up and in some landmark and famous cases. We learned about it extensively in just the second year of college.

My husband and I went through everything with my son for counselors, etc over the years and the one main theme I see as harming the transgender/transsexual community is that it is often tagged as being a repercussion of trauma. It also gives a more confusing viewpoint for cis people targeting the trans community as it should be seen in a medical and biological possibility.

My son was considered 'tomboy' back in the early 90's for his extreme dislike of wearing female clothing. At the age of 7, we moved into a new neighborhood. After a couple months of being there, there came a day when he didn't come home for dinner. It was a small neighborhood. I asked about my son by his female birth name and no one knew anything. At the last road, there was a group of boys playing and they said, "Is he related to Michael? Michael just moved in on your street." We later found out that he had gone out in his baseball cap (had long hair at the time) and introduced himself as Michael. He would tell parents of the boys he befriended that his parents couldn't afford good clothes so would get cast-offs from these same families. He would hide them under his bed and sneak out in them as I was pretty tough on him wearing nice clothes (not dresses but probably considered more girly and cute-he was 7). This had been an ongoing fight from the time he could choose what he likes and even one incident I can remember; he was very young-maybe 5, but not certain of the age, when he actually tried ripping up a dress before a funeral for my mother. He became pretty aggressive and I had to learn how to restrain him after 'temper tantrums' only when we were forcing the issue of clothing and things we purchased for Christmas, etc. We didn't do well for him and had no idea to look for anything other then anger issues. There were literally no past traumas nor abuse. However when he started counselors and even after for his transitioning medically, they were stuck on using past trauma to 'debunk his feeling transgender'. I went through more counselors then I can count the first two years and in two states for putting my son through hell this way and making him just more frustrated and angry. We did find some help through PP and only through them with full understanding. However, even my son will say there was nothing that made him angry nor traumatized. He just didn't feel like the person he saw in the mirror his entire life.

As parents, we are attacked for everything under the sun with him being transgender and it's cause. One person reacted to us supporting his surgery as being the cause of his wanting to destroy his body and brought up a ridiculously heated accusation about circumcision. Seemed the little group was just snowballing into this one since my son is almost 21 getting the surgery anyhow. Other times, the past trauma was connected as we apparently weren't digging deep enough and helping him be a different gender to the point of making his past worse when....there is no past; it's just assumed. These were the ones whom would at least try to give it a chance at understanding. It has hurt his chances and even an understanding of our support. It's difficult to even get through  to some counselors that my son was a well adjusted young man whom  was transitioning. He would talk to them about his feelings and guilt at being so different but at the same time, he was very firm that this was whom he was. They labored this for over a year trying to find something that caused this while he just wanted to start his t-shots and plans for surgery. I find linking trauma and other causes to gender dysphoria is extremely dangerous to the community and possible understanding of the biological chemicals that can be a contributing factor. I am a survivor of trauma due to molestation and later rape and abuse by an alcoholic husband before I was even 21. I have known many of those falling in that category (most of us agree that the generation of our parents [60's and 70's] produced probably the most messed up parents in history as the numbers for molestation and abuse in my age group that are coming out is staggering). I can't honestly see any link in this cause and affect theory for gender dysphoria on a level that would show this being the primary cause in average cases when compared to how many other forms of PTSD result from the same types of trauma. DID and other PTSD; absolutely. I suffer it as well in different ways. I think it can even be harmful in this correlation as the person being treated can be labeled with prejudice before the text book is even opened past page 1.

Worse, my son tried to commit suicide at the age of 18, was kept in the hospital then sent to a psych lock-up called LifeStream. They tried to blame past trauma on his thinking he is transgender and his feeling this way to his suicide attempt. Hmmm. We, and our son, were very clear that his suicide attempt was a result of living in a hick place with ignorant bullies that finally pushed him to that point after 3 years of it from family and friends until we could move out of there. And the fact that he felt he was a burden to his family due to the ignorance out there making him feel like he was called in vulgar and biblical terms. We had to drive out three hours to get to an advocate who would get him out of lock-up at this horrible place where they shoved him in a corner and kept using the wrong pronouns and mis gendering him trying to keep him indefinitely for evaluation and treatment.

Obviously, a lot more needs to be researched but it seems to be stunted with preconceived notions and confusions or labels and the need to group cases together. I can't contribute as to how one could feel the difference in DID or transgender but can say transgender individuals typically have a strong feeling consistently at their body and the skin they are in. I think the possibility of not having an awareness missing of altar personalities can be the only confusion which should be easily recognized when being confronted with stress or hypnosis and regression in counseling and therapy. If this isn't the first suggestion of a psychiatrist should a person seem to have doubts as to what they can be going through, then it's time to seek another professional.

Thanks tons for sharing your story; it's very important to understand the wide spectrum and complexity behind personality disorders, PTSD and and gender dysphoria.

@FamilyFarm
I am so very sorry to hear of the way the medical system treated you and your son. Your pain is clear in your post and resonates strongly with the misdiagnosis of my DID as transgender gender dysphoria.

A few things I would like to clarify:

Quote from: familyfarm on September 13, 2018, 03:58:38 PM
DID should be obvious to any decently trained psychiatrist as the personalities differ rather then one personality and not all altars are present at once.

If even more then one altar or personality presents in the course of a session, this is obviously not a case of gender dysphoria.

DID is EXTREMELY difficult to diagnose.
The differences between alters are typically very subtle. My wife of 25 years can tell which of my alters is fronting, but even she admits to the rest of the world the differences are barely noticeable or simply fly under the radar as personality quirks.

DID is often called a disorder of secrecy because the victims life depended on hiding what they were doing from their perpetrator.  Masking itself as a variety of other mental conditions, the average person is in the mental car system 10 years before they are correctly diagnosed with the disorder

Quote from: familyfarm on September 13, 2018, 03:58:38 PM
the one main theme I see as harming the transgender/transsexual community is that it is often tagged as being a repercussion of trauma.

The difference between gender dysphoria and other possible ptsd related diagnoses' are pretty distinct

Misdiagnosis hurts all patients, not just the transgender. That the differences between Gender Dysphoria and PTSD related disorders resulting from childhood sexual abuse are NOT distinct is the underlying cause of misdiagnosis. Abuse does not cause transgenderism. Given the high prevalence of childhood sexual abuse/trauma and the similarity of symptoms of transgenderism to those of trauma, it is the likely diagnosis for someone with transgender symptoms. It can take years of therapy to discern the difference, particularly for a transgender person child who experienced childhood sexual abuse.

Quote from: familyfarm on September 13, 2018, 03:58:38 PM
I think the possibility of not having an awareness missing of altar personalities can be the only confusion which should be easily recognized when being confronted with stress or hypnosis and regression in counseling and therapy. If this isn't the first suggestion of a psychiatrist should a person seem to have doubts as to what they can be going through, then it's time to seek another professional.

EMD, hypnosis and regression therapy are not used in the treatment of patients with DID. They are EXTREMELY dangerous because of the high risk of mental breakdown. I would run, not walk, from any psychologist whose first suggestion was any of these treatment options for DID.

So how long should someone with transgender symptoms spend getting checked for other conditions before transitioning? I'm confused again, because you seem to be suggesting that because transgender-like conditions are apparently more common than true transgenderism, that anyone with transgender symptoms should spend a lot of time getting "checked" first. And if it's so hard to tell the difference, how am I supposed to know what it is I have?

At the risk of going down an earlier rabbit hole:

Quote from: Lucca on September 13, 2018, 10:15:14 PM
So how long should someone with transgender symptoms spend getting checked for other conditions before transitioning? I'm confused again, because you seem to be suggesting that because transgender-like conditions are apparently more common than true transgenderism, that anyone with transgender symptoms should spend a lot of time getting "checked" first. And if it's so hard to tell the difference, how am I supposed to know what it is I have?

I'm not suggesting that  transgender-like conditions are more common than true transgenderism, I am saying that they ARE more common.

How long a person gets checked for other conditions before transitioning is between the person and their doctor.

There aren't any simple answers and no one can do this for you, Lucca. Each person has to do the hard work it takes to come to "know" for themself. As it is so hard to tell the difference, therapy is vital to help a person reach a point of clarity about why they feel the way they do. There are no guarantees. The forum is full of stories of people who detransitioned because they discovered it was not right for them and people who spent the best part of a lifetime trying to decide if transitioning was right for them.

But the regret rate for transition is so low, I don't see how there can be such a big problem with how transgender symptoms are treated. Plus, I haven't seen any of this corroborated by any legit medical sources that discuss treatment options for transgender symptoms. There are plenty of unscientific conversion therapy clinics who might agree, quoting Bible verses instead of real scientific evidence. With all due respect, forgive me if I'm skeptical.

Regardless of regret rate (And there are statistics as high as 33%), it's YOUR life at stake.

(EDIT: Insert note)
Note: statistic relates to the outcome of THERAPY not the outcome of actual transition

I am talking about extreme psychological disorder. Conversion therapies are no more effective for them than transgenderism. You won't find any of this corroborated by any legit medical sources that discuss treatment options for symptoms of transgenderism because NONE Of This Applies to Transgenderism.

There is a tremendous amount of good information in this thread. It might be helpful for you to print it out so you can discuss your concerns in therapy.

Where are you seeing a regret rate of 33%?

And I have read the thread, but I don't see much in the way of actual scientific evidence or research to support your conclusions, and they in go in direct opposition to everything I've read about successful treatment for transgender symptoms. You keep backing out by saying "none of this applies to true transgenderism." Well, yes, but if your argument is that it's difficult to determine if someone has true transgenderism or transgender-like symptoms, then that doesn't really mean anything.

Regarding these regret rates...

I am aware of only one source that consistently claims a persistent regret rate of more than a few percent, and as that source both has an agenda and does not substantiate the reported numbers I would have to consider them to be an unreliable actor.

There are reliable statistical studies on transition regret, both transient and persistent.

http://www.amsa.org/wp-content/uploads/2015/04/CareOfThePatientUndergoingSRS.pdf (http://www.amsa.org/wp-content/uploads/2015/04/CareOfThePatientUndergoingSRS.pdf)

Quote
With any irreversible medical procedure there is a risk of patient dissatisfaction, and primary care providers are often concerned that their transgender patients will experience regret following SRS. To address this concern it is helpful to understand (a) the incidence and causes of post-surgical regret, and (b) protective measures in place to help prevent regret following SRS.

Temporary concerns are relatively common after any surgery, and (in both the transsexual and non- transsexual literature) typically relate to post-operative pain, surgical complications, discrepancy between hoped-for results and actual results, and initial difficulty adjusting to the impact of surgery on immediate relationships.2 Dissatisfaction, disappointment, doubt, or other psychological difficulties that represent normal adjustment and resolve (spontaneously or with psychotherapeutic assistance) in the first year after surgery are distinguished from a persistent wish that surgery had not been pursued.

Persistent regret is more rare following surgery, and may (for reversible surgeries) be accompanied by a request for surgical reversal. In studies of non-transsexual individuals who reported regret following a variety of surgical procedures (including surgical sterilization,15-19 mastectomy,20-25 breast reconstruction,23,26 breast augmentation,27-29 oophorectomy,30 orchiectomy,31 limb salvage surgery,32 gastric banding,33 and colpocleisis34), the regret rate ranged from <1% to 23%. The reported reasons for regret included adverse physical effects of surgery, loss of physical functioning, poor aesthetic result, failure to achieve desired effect, lack of support available before and after surgery, change in intimate relationship, psychological issues not recognized prior to surgery, and incongruence between patient preferences regarding decision involvement and their actual level of involvement.

Persistent regret among post-operative transsexuals has been studied since the early 1960s. The most comprehensive meta-review done to date analyzed 74 follow-up studies and 8 reviews of outcome studies published between 1961 and 1991 (1000-1600 MTF and 400-550 FTM patients).3 The authors concluded that in this 30 year period, <1% of female-to-males (FTMs) and 1-1.5% of male-to-females (MTFs) experienced persistent regret following SRS. Studies published since 1991 have reported a decrease in the incidence of regret for both MTFs and FTMs that is likely due to improved quality of psychological and surgical care for individuals undergoing sex reassignment.

Numerous studies have explored clinical practices that may help in the prevention of regret following SRS, and negative prognostic factors. There are three key factors in persistent regret following SRS: (a) incorrect diagnosis of gender dysphoria or of co-existing psychopathology, (b) poor quality of surgical intervention, and (c) lack of ability to live in the desired gender role.2,5,40 The latter issue is influenced by numerous psychosocial issues, including lack of support by loved ones, psychological dysfunction, fluctuating gender identity, and insufficient professional support during treatment.35,37,40 None are considered absolute contraindications for SRS, but all are considered risk factors that warrant careful clinical attention. The HBIGDA Standards of Care require "real life experience" (RLE) in the desired gender role as part of the pre-surgical evaluative process prior to genital surgery or gonadal removal. The RLE provides an opportunity to evaluate the impact of transition on the patient's support network (loved ones, friends, etc.), and the impact of the stresses of transition on the patient's psychological resilience.

Inaccurate diagnosis of gender dysphoria or co-existing psychopathology and poor quality of the surgical intervention relate to clinical competence for mental health professionals and surgeons involved in transsexual care. The HBIGDA Standards of Care outline competency requirements for clinicians involved in SRS, and HBIGDA also provides opportunities for scientific interchange among professionals through its biennial conferences, publications, and email discussion lists. The Transgender Health Program (Appendix A) coordinates training for surgical assessors who have the professional credentials required by HBIGDA and the BC Medical Services Plan.

As discussed above, the HBIGDA Standards of Care state that pre-operative counselling is at the discretion of the mental health professional(s) conducting the assessment of surgery eligibility and readiness. While psychotherapy is not an absolute requirement for SRS, supportive professional and peer counselling can be helpful with preparation and adjustment, and should be accessible to all patients before and after surgery. The primary care provider can assist by discussing patient awareness of resources and, where needed, facilitating referrals to trans-experienced professionals.

A combination of reasonable psychotherapy care, real life experience, and a decent surgeon seems to be the best way to avoid perisistent regret over transition. 

I don't remember if I've posted in this thread before or not, but considering I happen to be a person who regrets a gender transition surgery (ftm mastectomy) perhaps I have an opinion on this discussion in general. Or at least, I have my personal story and conclusions of it.

For me it was because of underlying psychological issues that I was not aware of before the op. Or rather, not fully aware of what they actually meant, but I was aware of their existence. I started being vaguely aware of the impact of my decision to have surgery already one month before my op though. But I was so certain that I actually wanted the surgery and that my struggle was only because of normal nervousness of getting invasive surgery for the first time ever, as well as a reaction from my nicotine withdrawal from me quitting smoking.

But in retrospect that was not normal surgery woes or just withdrawal woes, but a full on rampant panic that kept going 24/7 for 5 weeks. My gut feeling tried to scream sense to me, but I didn't listen to it. I recognised that feeling for what it was because then 4 years later the same thing happened with my mind when I was planning to get bottom surgery, but then I finally learned my lesson, listened to my body and cancelled that planned op before it could take place.

By the time I got my mastectomy I had been living "RLE" and binding my chest, and been in gender therapy, for 5 years.

After the op I had trouble adjusting to the result and I was in some sort of shock about it, but I couldn't understand why. I reasoned back then that I wished I had chosen a different method for my mastectomy, cause I was insecure about my scars. But I was very uncomfortable showing my chest to anyone, even after it had healed up. The result in and of itself as good, so it wasn't that that bothered me, but I was still in emotional distress about it.

In retrospect I now get that I was probably having a huge internal fight with myself that I simply "should" have been satisfied and beat myself up for feeling what actually was regret. About a year after the op I started getting used to it and was less bothered, even found some things I liked about it, but I was still very uncomfortable with being flat-chested. It felt unnatural and alien to me. That feeling never went away. I very much deflected and ignored that I did miss having breasts.

It's now been 4 years since the op when I finally faced my fears and stopped running from my true feelings. They hit me hard. At first I made a last desperate attempt to reject my feelings, but then let them come to me. Eventually feelings of a heavy sadness, regret, feeling broken and a huge disconnect to my body revealed themselves to me. Now I know getting a mastectomy was a big mistake for me. It essentially created a gender dysphoria I didn't have previously, but thought I did, and that caused a very confusing distress in my mind.

From my own perspective of my own situation in regards to gender reassignment surgery regret:
- The gender clinic I initially went to was iffy but ultimately it was not their responsibility to make me tell them the truth that I refused to tell them; that was on me.
- The second gender clinic I went to (for second opinion, kinda) only did all they could to help me with the information they had about my case; the therapists were great there.
- The surgeon who did my op was also great and did a good job, he offered me a revision that I didn't take, I had no complications, I healed well, the result was objectively good. He's largely unknown and was new to ftm mastectomies at the time which makes his performance even more amazing to me; so I have zero reasons to blame him.
- There was nothing no one could have done to prevent me from getting the surgery that I then regretted, I was determined to get it, so to the point I was willing to lie for it.
- I have no one to blame but myself.
- Forgiving myself for having effed up my body is a lot harder than throwing blame on others, but it is the mature and wise thing to do, and I'm trying to.
- It hurts but literally the only actually good things I can do from here on is to be honest and stop with the lying, to look into what I can do to reduce my emotional pain of regret and the disconnect I have to my body that arose from having had that surgery (as in look into reconstructive breast augmentation surgery), get therapy on my underlying issues, and for once just listen to my own body and mind. Move forward, and try not to drown in my grief and throwing blame around.

My opinions on this topic in general:
Regret happens and it cannot be 100% prevented. And sometimes it's not the docs fault even though they obviously have some responsibility and ofc in some cases malpractice happens. But I don't think they have full responsibility. If they're honest and clear about what it all entails and leave the decision up to the patients, the patient also has a part of that responsibility. Care and support should be given to those who experience regret, especially therapeutic help but ofc also surgical help if necessary and/or requested by the patient.

Also, good link you shared, Michelle_P :)

Thanks for your story. Yes, regret certainly does happen, but I'm lead to believe that it's both uncommon, and even further minimized if the individual seeking treatment is honest about their feelings. I'm just confused in regards to what Virginia is saying, because it goes completely against all of my own research on the subject, which suggests that treating people who have "transgender symptoms" with transition has a very high success rate. Virginia keeps saying that it's more likely that people with transgender symptoms aren't transgender and therefore trauma-related disorders should be the first assumed cause, but when I push for more details, I'm just told that none of this applies to transgender people, so I don't need to worry about it ???. I don't want to ruffle any feathers this time, I just can't figure out what he's talking about.

In my therapy sessions I decided when starting that I had to be brutally honest, that obfuscation would just slow or stall my healing process.

When I read about folks who are afraid to disclose their feelings or thoughts within therapy, I worry about their results or lack of progress. While therapists are trained to spot avoidance and misdirection, sometimes patients are awfully good at it. That may make the patient less uncomfortable but it does them no good.

There is some responsibility on the patient to be honest and as open as possible with the therapist, just as the therapist must fully evaluate the patient.

Psychotherapy is a two way street.


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Quote from: Lucca on September 14, 2018, 02:01:50 PM
Thanks for your story. Yes, regret certainly does happen, but I'm lead to believe that it's both uncommon, and even further minimized if the individual seeking treatment is honest about their feelings. I'm just confused in regards to what Virginia is saying, because it goes completely against all of my own research on the subject, which suggests that treating people who have "transgender symptoms" with transition has a very high success rate. Virginia keeps saying that it's more likely that people with transgender symptoms aren't transgender and therefore trauma-related disorders should be the first assumed cause, but when I push for more details, I'm just told that none of this applies to transgender people, so I don't need to worry about it ???. I don't want to ruffle any feathers this time, I just can't figure out what he's talking about.

I feel inclined to disagree with Virginia on that point. According to the sources I've found, I agree with you that it's very rare that regret happens and the vast majority of people who transition end up satisfied, or at least, at a better place mentally than they were prior to transition. So yes, I agree it has a very high success rate.

I know it's not a very all encompassing source at all, but I looked at the regret statistics of that are stated on the website of the gender clinic I'm going to (the largest one in my tiny country of only 9 million people) which says that around 1000 people have transitioned via the Swedish system and applied for legal gender marker change, while only 15 of them have applied to get their gender marker changed back to bio gender. And that's for the past 46 years since transitioning became possible here in 1972. Ofc people have detransitioned earlier in transition than to the point of gender marker change, so that's why nose numbers are not all that all-encompassing, but I think they may give a very rough estimation that regret is very rare if I'll be the 16th person ever in Swedish history to change gender marker back again.

Well, I think that largely transgender health care is going well, and I'd worry that including more in depth therapy to rule out other issues could make it worse for that majority of those who seek such care who are trans and just want to get on with transition and their lives.

I think if anything, it would be good to put some pressure on the (hopefully few) docs who don't do their jobs right and mistreat patients seeking trans care out of negligence. But, I think that's a very reasonable wish to have on health care in general and isn't just applicable to trans health care. And maybe have more research be put into it so that trans health care can be improved both for those who are trans and those who think they are but turn out not to be. I just mean that if improvements are to be made, I don't think one camp should have to suffer for the sake of improving care for the other camp.

I haven't read through the entire thread, but I saw some of VA's posts about that supposedly a thid of all transitioners regret it, without showing sources. You have every right to ask for sources before believing in something, so I get that's a bit frustrating. It might be so that very many of those who do regret it do so because of trauma-related issues, but that would say nothing about regret rates in general.

Quote from: Michelle_P on September 14, 2018, 03:04:13 PM
In my therapy sessions I decided when starting that I had to be brutally honest, that obfuscation would just slow or stall my healing process.

When I read about folks who are afraid to disclose their feelings or thoughts within therapy, I worry about their results or lack of progress. While therapists are trained to spot avoidance and misdirection, sometimes patients are awfully good at it. That may make the patient less uncomfortable but it does them no good.

There is some responsibility on the patient to be honest and as open as possible with the therapist, just as the therapist must fully evaluate the patient.

Psychotherapy is a two way street.

I agree with you on that point, but I didn't in the past. I thought I knew myself better than they did and had huge trust issues towards the entire health care system. Yeah I got good at lying but it did me no good. Well, except from that it taught me a lot about how not to behave in therapy and exactly why it was bad and what consequences it could lead to.

Now when I speak to therapists I tell them the truth as much as I can, and when I struggle with that I say "I'm not comfortable sharing this right now" as well as informing them of my trust issues.

I'm just adding this short reply to you here to say I was an idiot to behave like that, but I learned and understand that now, and have changed. So it took me a long time and lots of unnecessary suffering, but now I get it ;) Pain is a very effective lesson, sometimes.

Quote from: Dena on July 28, 2018, 02:54:05 PM
Lucca, Virginia is offering the best possible explanation one can offer from the position of having DID. The transgender diagnosis was forced incorrectly by the therapist and it became a matter of digging out the truth. Virginia is here to watch for others who might fall into this trap. It has happened to another member of the site who was able to receive surgery only to discover the mistaken diagnosis. Remember that the opening post isn't so much about being transgender but is about having DID and being misdiagnosed with transsexualism.

Quote from: Lucca on July 28, 2018, 10:44:53 AMAll I wanted was an explanation of what differentiates DID from transgenderism, and how a psychiatrist would distinguish one from the other in a diagnosis. I initially was not given such a thing, was then derided for asking for it, and am now being derided for having received it. Great. I've learned nothing except to avoid the topic at all costs.

If you have a skilled therapist, you state your transgender and you exhibit the symptoms of being transgender, the therapist will have few options other than to diagnosis you as transgender. Transgenderism is a self diagnosed condition so the therapist's purpose is to verify what your saying and determine that there are no other conditions that would interfere with your judgement. The therapist isn't there to diagnosis you though they might make suggestions for you to consider.

DID is another matter because often people who suffer from it aren't aware that they have it. They have gaps in their memory much like you do when you sleep or they might remember the actions of their alter as a dream. The reason they don't realize this is abnormal is because it's all they have ever known so they are unaware of what everybody else experiences. There is an element of self denial when somebody describes an action they took that they lack the memory of.

A good therapist is unlikely to diagnosis you as DID unless a symptom indicates the possibility. This is a relatively rare condition and even when a therapist suspects it, they will have to do a good deal more digging for supporting evidence. The therapist is looking for anything that might affect your judgement and bipolar or schizophrenia are more likely possibilities than DID.

If you should ever disagree with a diagnosis you receive from your therapist, demand the reasons for the diagnosis. If you feel the therapist is wrong, you have the option of discussing it here or seeing another therapist for a second opinion. If a therapist isn't a good fit, there is no reason why you should stay with them.

:police: Also remember that I am watching this thread and the inability to answer a question isn't a reason to be upset. Try waiting for somebody else to answer the question or try to rephrase the question. Sometimes there isn't an answer to a question so forcing the issue isn't going to provide an answer.   :police:

I'll just put out here that I like my current therapist, I think she's the tenth one I've seen in my life, and the only one who's actually helped me significantly. She's very oriented towards giving me the agency to make my own decisions about my own life, while my past ones usually weren't. They always wanted to form their own inferences about why I was the way I was and didn't want to let go of them. That does include a therapist who was too pushy about me transitioning, and I found it very off-putting.

Hence, I'm a bit touchy at the idea that therapists should presume I have trauma before anything else and spend, what, ten years figuring out if I have DID? I'm still unclear on that. I mean, that story that familyfarm told is an example of how prevalent the "this is caused by trauma and transition needs to be prevented at all costs" mindset can be. I'm not going to put up with going through that.

EDIT: Ok, is there some purpose to quoting a moderator's response to me with no other content? I remember what it said. I didn't realize that calmly asking questions was against the rules.

Quote from: Lucca on September 14, 2018, 03:51:35 PM
EDIT: Ok, is there some purpose to quoting a moderator's response to me with no other content? I remember what it said. I didn't realize that calmly asking questions was against the rules.

It isn't. :)

Quote from: Lucca on September 14, 2018, 03:51:35 PM

EDIT: Ok, is there some purpose to quoting a moderator's response to me with no other content? I remember what it said. I didn't realize that calmly asking questions was against the rules.

Quote from: Sephirah on September 14, 2018, 04:18:54 PM
It isn't. :)

Well, I  sure got in plenty of trouble doing it!  :laugh:

Myth: Most people regret transitioning / surgery
This is untrue. The regret rate for sexual reassignment surgery ranges from about 0-2% as reported by most recent studies on the subject. (For comparison's sake, the regret rate after cosmetic surgery hovers at around 65% in the UK, but it has not received anywhere near the same level of public moral concern.)
https://www.researchgate.net/publication/262734734_An_Analysis_of_All_Applications_for_Sex_Reassignment_Surgery_in_Sweden_1960-2010_Prevalence_Incidence_and_Regrets (https://www.researchgate.net/publication/262734734_An_Analysis_of_All_Applications_for_Sex_Reassignment_Surgery_in_Sweden_1960-2010_Prevalence_Incidence_and_Regrets)
http://www.amsa.org/wp-content/uploads/2015/04/CareOfThePatientUndergoingSRS.pdf (http://www.amsa.org/wp-content/uploads/2015/04/CareOfThePatientUndergoingSRS.pdf)
Both papers site a 1-2% regret rate.

I think this shows that "on the whole" the various systems in the world work to weed out the people that this is  not appropriate for. Therefore I believe, that the 33% rate quoted  is people who start on the road to transistion and then before GRS decide not to continue as they realise it is not the "correct" path for them. That would explain why the regret rate is so low. So it is a little like comparing apples and pairs with the statistics quoted by everyone?

@septagonscars - You write as a beautiful and intelligent human being. You made choices in your life that, for you at the time, were right. They now turn out to be not ideal but I really think you are being overly tough on yourself and beating yourself up a little too much (a common trait with dissociatives BTW). Try not to dwell on the past too much and celebrate the amazing person you are now and your future. Very few humans get to live a life like you have.(and being multiple is amazing and beyond the scope of singles understanding). xx

@Familyfarm - You sound an amazing parent. I wish you were my mother!

Take care
Sarah x

Quote from: SoupSarah on September 14, 2018, 07:20:40 PMI believe, that the 33% rate quoted  is people who start on the road to transistion and then before GRS decide not to continue as they realise it is not the "correct" path for them.

Thank you for clarifying, Soupsarah. That is how the 33% rate was explained to me by my psychologist. It relates to the outcome of THERAPY not the outcome of transition; the reason I quoted it in my reply above.

Ok, that makes more sense then. I still don't see that anyone's given a source. In which case, it's fine for anyone who's received the information from a source they consider reliable to believe it, but I'm nuetral about it until I've seen evidence. I'm not sure why it's controversial that that's what I'd expect.

I'm all for people receiving the help they need, and not being pushed to transition if they don't want it. What I'm not for is the mental health professional community deciding that there's one condition I "probably" have before they've considered my full input, or putting roadblocks in my way to prevent me from transitioning when I'm perfectly capable of making my own decisions and have already spent many years figuring myself out. I'm not for inaccurate statistics or drawing unwarranted conclusions from unrelated sets of statistics, either. If you aren't for any of those things, then there isn't a problem.

I'm just trying to have a civil conversation on a topic that you ultimately brought up when you created this thread, Virginia. I don't know what I did to offend you so much that you quoted the moderator's post back to me. I think I've kept a level head this time.

@Lucca
Thank you for noting I am a man and for not using genderless pronouns when referring to me.

Quote from: Lucca on September 14, 2018, 10:23:14 PM
What I'm not for is the mental health professional community deciding that there's one condition I "probably" have

I'm not for inaccurate statistics or drawing unwarranted conclusions from unrelated sets of statistics, either.

The point of my entire post is to make people aware that "the mental health professional community deciding that there's one condition I 'probably' have" and  "inaccurate statistics or drawing unwarranted conclusions from unrelated sets of statistics" LED to the misdiagnosis of my Dissociative Identity Disorder as transgender Gender Dysphoria.

Ok, if you're not going to actually back your statements up and are just going to go around in circles instead, I don't see a point in continuing this conversation.

There are quite a few studies that have been done on children with GD who later go onto transition. I think the data is harder to ascertain with adults, but a credible, peer reviewed, one is below:

https://jaacap.org/article/S0890-8567(13)00187-1/fulltext (https://jaacap.org/article/S0890-8567(13)00187-1/fulltext)

and a discussion of the results here:
https://jaacap.org/article/S0890-8567(13)00185-8/fulltext# (https://jaacap.org/article/S0890-8567(13)00185-8/fulltext#)

In the study, 127 children under 12 who had been referred to MH with GD were followed up in adolescence.Of the whole cohort, 47 of them went on to transition from their assigned birth gender.  The remaining 80 remained in their birth gender. The study and discussion go into the various reasons and factors. But in children with intense GD there is a 63% desistance according to this study.

Quote from: SoupSarah on September 15, 2018, 10:49:20 AM
There are quite a few studies that have been done on children with GD who later go onto transition. I think the data is harder to ascertain with adults, but a credible, peer reviewed, one is below:

https://jaacap.org/article/S0890-8567(13)00187-1/fulltext (https://jaacap.org/article/S0890-8567(13)00187-1/fulltext)

and a discussion of the results here:
https://jaacap.org/article/S0890-8567(13)00185-8/fulltext# (https://jaacap.org/article/S0890-8567(13)00185-8/fulltext#)

In the study, 127 children under 12 who had been referred to MH with GD were followed up in adolescence.Of the whole cohort, 47 of them went on to transition from their assigned birth gender.  The remaining 80 remained in their birth gender. The study and discussion go into the various reasons and factors. But in children with intense GD there is a 63% desistance according to this study.

Not exactly.

They found a correlation between the intensity of gender dysphoria and the persistence of it.

This is basically a validation of the older "persistence, consistence, insistence" test used for childhood gender dysphoria.

Gender questioning behavior is often tagged as potential gender dysphoria.  Combining gender questioning and dysphoria as childhood gender dysphoria produces the artificially high desistence rates for children. 

Quote
Objective

To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence.

Method

The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (<12 years of age) and followed up in adolescence. We examined childhood differences among persisters and desisters in demographics, psychological functioning, quality of peer relations and childhood GD, and adolescent reports of GD, body image, and sexual orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence.

Results

We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls.

Conclusion

Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD.

Whilst I respect your input, I would question your dismissive "Not exactly".

I did choose this study specifically because the cohort of children was pulled from a specialist gender clinic in Amsterdam. The subjects in question had been referred to the clinic due to Gender dysphoria by teams in their locality. In fact the authors actually state that due to the supportive climate in Amsterdam of GNC youth their sample could be biased with a population with more acute GD, because milder cases would not be referred.
Of course all patients attending the clinic would be gender questioning, you cannot remove them from the statistics because they later do not transition? You would then only end up with a 100% transition rate and the study be pointless. It also casts doubt on the poor individuals who have GD and choose not to transition as to the degree of suffering they are going through - It is possible to have GD and not be trans, the GD is still just as bad. I speak from experience.

The question running in the post is "Is there any scientific evidence for the stated 33% of people who start transitioning and later stop " as quoted by virginia's psychiatrist - Whilst I am aware the study i listed was focused on finding correlations with intensity of GD, It does also highlight that a large proportion of those cases entering the specialist clinic for whatever reason, decide not to transition. I am also inherently  aware that the question on this thread is about the general population and this is study specifically looks at pre-adolescents with all of the factors associated with that cohort. However it seems figures for any adult studies are difficult to ascertain. It at least gives some unbiased research that has been asked for by other respondents to this thread.

I appreciate the source, I will certainly read it and consider it.

Thank you for doing the hard legwork to find this reference, Soup Sarah.
My psychologist has worked with the transgender community and people with eating and trauma related dissociative disorders for 40 years, and has been treating me for over 7. I have long since stopped asking her for "references" about the things she tells me.

Quote from: SoupSarah on September 14, 2018, 07:20:40 PM
@septagonscars - You write as a beautiful and intelligent human being. You made choices in your life that, for you at the time, were right. They now turn out to be not ideal but I really think you are being overly tough on yourself and beating yourself up a little too much (a common trait with dissociatives BTW). Try not to dwell on the past too much and celebrate the amazing person you are now and your future. Very few humans get to live a life like you have.(and being multiple is amazing and beyond the scope of singles understanding). xx

Take care
Sarah x

Thank you. I know I'm being hard on myself. But I think the main reason for that is because despite having so much understanding of my situation and taking responsibility for it, I too sometimes deflect and throw blame around cause the pain in me is just too much for me to handle sometimes and I just want for it to be someone else fault that I could direct my anger and pain towards. So then I need to kinda snap myself back to reality again, and I probably do that a bit too hard. I can't really do things gently or just a bit. I'm a person of extremes, so it's always either or, meaning either being too hard on myself or being too soft on myself. But I try to not do that too often or too much.

I'm actually glad that very few people live the kind of life I do. No one deserves this, and no one should have to suffer this kind of pain. I'm finding roads to my future by dwelling on my past, so I am actually moving forward while glancing back. I use my past as kind of a road map for where to go next. And the dwelling also helps me better understand myself, as well as better accepting and becoming okay with my past. It's kind of like my own personal exposure therapy.

I think there are def good things about being multiple, like it can be a great comfort and support. At least now that my one alter is not abusive anymore. But I'd probably not go as far as calling my situation with that amazing ;) However, I would not actually want to not have an alter now, or to integrate. But likely because I've come very far with her now and found/created a beautiful friendship that I don't wanna lose. And because I'm so used to not having my mind to myself xD. I mean, it's positive for me now, but it does still have its downsides.

But anyhow, your words are very kind :)

So people who have experienced trauma are then more likely to transition genders than those who haven't? I'm confused about this... Or is it that being another gender is one symptom of DID?


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Quote from: Allison S on September 16, 2018, 05:05:46 PM
So people who have experienced trauma are then more likely to transition genders than those who haven't? I'm confused about this... Or is it that being another gender is one symptom of DID?

Transgender people share many of the symptoms commonly experienced by cisgender men who were sexually abused as children. Sexual fantasies about becoming a woman, the need to dress as woman, extreme guilt related to masturbation, gender confusion, sexual confusion, and/or dysphoria about their genitals. One in six men are sexually abused, so it is much more likely a person may be experiencing these symptoms as a result of their sexual abuse rather than being transgender (16% versus 0.6%.) References are cited throughout this post.

It is very common for people with DID to have different gender alters in their systems. Male alters give female trauma victims the strength they do not believe themselves to possess as women. Female alters give men a way to justify in their minds the horror of having been molested and a way to resolve the resulting sexual confusion. Alters have nothing to do with gender. They are a coping mechanism for containing the feelings and memories of trauma.

Quote from: Allison S on September 16, 2018, 05:05:46 PM
So people who have experienced trauma are then more likely to transition genders than those who haven't? I'm confused about this... Or is it that being another gender is one symptom of DID?

Ahh - I see virginia beat me to the post - Oh well, I send this up anyway it might help?

It is confusing quite a lot, I think the thread has lost a little direction. But basically:
DID is a trauma based psychology sometimes called multiple personality syndrome. It is not at all like anything depicted on TV or the movies but does involve the individual experiencing parts of themselves that are different in terms of personality, gender, sexuality and/or mannerisms. It is so complex that usually any one part does not understand they are just a part, and so when other personalities (or alters) are around they can change how a person thinks. Sometimes this "take over" is complete and only the current part is out and running the show, other times there is a blend or seep through of thoughts and consciousnesses. So an individual with a male and a female alter can mistakenly think they are transgender. Every "symptom" of being transgender is present, over-ridingly gender dysphoria. Sometimes alters can take over for years at a time, sometimes it is only minutes and then sometimes it can be a mix or other complex situations. The point is it is hard for the individual to understand as the different parts have different levels of consciousness of what is going on.
What DID is not is in any way defining a person as transgender. Transgender is defined differently AND is completely different. For a start it is not a mental illness, it is a state of being.
DID is usually caused by some severe trauma before the age of about 8 years old. Usually it is CSA (about 95%). The sufferer of DID is also usually totally unaware of this trauma as this is what DID is all about, locking atrocious memories away from the main consciousness so it can function as normal. So it is not as simple as saying, I feel I should be the opposite gender to my body and I had no trauma as a kid so I must be transgender. For that is what nearly all DID people would conclude. Only by exploring in therapy, with a skilled therapist would it actually be able to identify DID.
So, here on in, is the dilemma. While it is great that there are less and less barriers and more acceptance to people transitioning, there are a few of us (e.g. SeptagonScars, Virginia and me) whom it is actually detrimental, and detrimental in a potentially devastating way.
I am in the UK, and despite overwhelming evidence of early childhood trauma a senior psychiatrist in the NHS diagnosed me as "transsexual in denial" and suggested I transition. A part of me (actually me typing this!) really, really wants to do this. I have debilitating GD and a complete loathing for my body. Left to my own devices I would readily agree with that diagnosis and be on the road to transitioning. Luckily, whilst posting on susans last year Virginia spotted my post and made a suggestion about what I had written. Something I had not considered, that I was mentally ill. I came here, to susans for help and by gods grace Virginia found me and saved my life.
That is why this little thread, this small piece of the amazing support work that susans.org does is so important.

I hope that clears it up a little? If not ask questions :-)

Thank you both, Virginia and SoupSarah. I have a lot to think about...
Did you mean that CSA can manifest solely as gender dysphoria or someone's extreme discomfort with their gender assigned at birth?
I just think it's incredible what our minds can do to protect ourselves. In a way, and I know I'm making assumptions, but that can point to being transgender as evolutionary. For some, it's (very sadly) triggered by horrible acts. And for others it's innate...

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Its probably a lot more specific than just CSA, it also thought that only a certain "type" of mind can dissociate to such an extent and you need to be in a situation where parental support is not conducive to being able to remedy the trauma as it happens. It is almost like a roadmap, if someone is DID.

I am a woman. I think, feel and act as a woman. Everything about me is female except my body. I look in the mirror and hate my beard, genitals and lack of chest. Everything actually about my body is wrong because it is male. Any test to determine if I should transition would give a resounding yes, full transition with SRS. BUT I am not transgender and that is tough and difficult to live with. So, not just CSA is needed and the results for a part can be very simmilar to an innate transgendered individual.

The evolutionary thing is a good angle. DID is a coping mechanism designed to allow a person to function despite trauma early in their lives that they could not fight or flee from. If a sabre-toothed tiger attacked and killed your entire family, (and the other parts of DID, brain, upbringing were true) you would not remember them being slaughtered. You however would probably not have another gendered alter, the trauma caused by a violent action, you could have a part that would fight a tiger, another tiger? or a strong, butch man. Something to protect you.
In my case I was abused by a homosexual peadophile between 2 and 4/5 years old. I was created as a female, because it would not of happened to me. He liked little boys, not little girls. So it is not an automatic thing, just most trauma suffered in the western world by children is sexual by nature.

Sorry if I'm changing the point of the topic. I just get a thought and run with it sometimes... I get a bit carried away.
And by evolutionary, I think I meant biological.
I wonder, since the man that violated you is known to be "gay" or only interested in young boys... Has this deterred you from a relationship or intimacy with a man?
I understand if this is intrusive to ask. I'm just trying to understand better.
I'm pretty sure I'm transgender... I also know I struggled with trauma, though non sexual, I don't think...
I really think this is a topic we need to talk about more in society. And I really wish we do.

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Allison S - Thankyou for being so interested. Your educated responses and questions are more than welcome and I am happy to talk about it.
Virginia - Sorry for the slight hijack, but please feel free to jump in and correct me, I will always defer to your greater knowledge of the subject :-)

So first of I just want to make clear that being transsexual is an innate state of being. Your born with it. DID is a trauma created mental issue. If I had not gone through the type of childhood I did, I would not be dealing with this now. I am the female part of our system and can identify and understand the issues someone who is transgender goes through. In my mind I have always been female, innately. As I share a body, I have to be considerate to the other parts. A bit like a flat share :-) That said, I can pass fairly well as female if I want to as my mannerisms, speech patterns and thoughts are very feminine.

Sex is a difficult subject to talk about. My male part is heterosexual and married. They have difficulty forming relationships and tend not to favour the company of men. That could be due to the early trauma, but it is not clear yet. I believed that I was lesbian tending bisexual. But I now understand that it is simply with a male body I could not have a relationship with a man. I could not engage in gay sex if you get my drift. Probably due to the trauma as well, who knows. But, my dreams whilst never sexual, have been about getting married to a man. In those dreams, I have the correct body. The idea of therapy is to try and integrate all the parts into one functioning personality. That is a very long way off for me (and as septagonscars noted above may not be the desired outcome for us?). If we do integrate then I suspect that this duality of gender and sexuality will settle on a single path. Where that will be is unknown, but if I am honest it would probably be more in line with my other part, male and heterosexual. But no-one actually has any idea.
Exploring your gender with a trained and knowledgeable therapist is the best way to understand your feelings and vitally important for anyone embarking on transition. 

Quote from: SoupSarah on September 17, 2018, 09:45:28 AM

Exploring your gender with a trained and knowledgeable therapist is the best way to understand your feelings and vitally important for anyone embarking on transition.

Thank you. I think that's key here. I see it like a puzzle in a way...

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You are very welcome, AllisonS. SoupSarah and I are both passionate about sharing our experience to help anyone exploring their gender.

Quote from: Allison S on September 16, 2018, 09:28:06 PMDid you mean that CSA can manifest solely as gender dysphoria or someone's extreme discomfort with their gender assigned at birth?
I just think it's incredible what our minds can do to protect ourselves. In a way, and I know I'm making assumptions, but that can point to being transgender as evolutionary. For some, it's (very sadly) triggered by horrible acts. And for others it's innate...

I am a successful graduate level engineer. Had I not experienced it for myself, I would be in total disbelief that my mind could hide the horrible things that happened to me so completely I had ABSOLUTELY NO AWARENESS OF THE EVENTS.

I am not sure I can concur with the idea that this in any way can point to being transgender as evolutionary or triggered by horrible acts. The things I describe are normal to CSA. Transgenderism is an innate state of being, not any sort of triggered disorder or psychological response by trauma. However similar Gender Dysphoria may appear to the symptoms of someone who is a survivor of childhood sexual abuse, the underlying causes of the two are completely different.

It takes a very specific set of circumstances for a person with a dissociative mind to develop separate identities as a result of childhood trauma (sexual or psychological), But Childhood Sexual Abuse CAN Manifest As "Gender Dysphoria." Cisgender men who are survivors of CSA experience sexual fantasies about becoming a woman, the need to dress as woman, extreme guilt related to masturbation, gender confusion, sexual confusion, and/or dysphoria about their genitals. There is an excellent discussion group on the Male Survivor website at: http://www.discussion.malesurvivor.org/board/ubbthreads.php?ubb=cfrm

This complicates diagnosis for a person who is dissociative and developed DID with opposite  gender alters. Even more so for a transgender person who experienced CSA or has Dissociative Identity Disorder. I refer you to my female alter, Flytrap's intro post which has become the "home" for forum members with dissociative conditions who need to express themself as another gender at https://www.susans.org/forums/index.php/topic,218553.msg1934547.html#msg1934547

Quote from: Allison S on September 17, 2018, 08:52:32 AM
I wonder, since the man that violated you is known to be "gay" or only interested in young boys... Has this deterred you from a relationship or intimacy with a man?

In my case I was repeatedly molested by my Mother through grade school and raped by a 13-year-old cousin when I was 6. Sexual abuse runs on my Mother's side so my perpetrator was likely abused by his Father. My experience left me incapable of intimacy with anyone.

Sex between young boys is about exploration and, like men in prison, availability of a partner to fill their needs, not being gay. It's healthy and normal cisgender activity between consenting partners.  An adolescent forcing himself on a six-year-old is a devastating violation. A child's mind is not developed to handle the psychological overload; orgasm literally explodes their mind.

I don't think it's possible for anyone with a single identity to comprehend how amazingly effective dissociation is as a coping mechanism. Effects of trauma, like deterring intimacy, are minimized for the Primary alter/Apparently Normal Part. They can often go on to live a normal life, free of the psychotic disorders a person who was not dissociative might experience and aloof to the devastating effects of the trauma contained in their alters.

My female alter, Flytrap, is not capable of responding to a thread like this the way SeptagionScar or SoupSarah can. Partly because Flytrap is only 13 and has difficulty putting her thoughts on paper. But more importantly because it threatens the self-delusion my mind uses to maintain that part of Self as a separate person. You would notice a glaring difference in each of our writing styles; my posts are factual and formal; Flytrap talks about feelings in simple sentences.

I am the Primary Alter of my System, enjoy being with and relate well to other men; not so much with women, excepting my wife. My fragment alter is our System Protector, so I tend to be extremely Alpha male. Flytrap relates equally well to women and men. She is sterotypical woman because that isthe role she was created to fill in our System. In casual relationships we both appear very well adjusted, outgoing, caring and personable. That my System works so well in simulating a "normal" person is why I was able to live a happy life for 48 years and it has survived with very little change for nearly 60.

Flytrap is asexual, Little Guy is too young to be concern himself with sex, and my Protector and Inner Self Helper have no gender or sexual orientation. In my mind's elegant solution to appear normal, I am heterosexual,  But I have NEVER been able to bring myself to have sexual intercourse. And it tears my wife of 25 years heart out that I am just not capable of the trust an intimacy most people  who are married take for granted.

I'm sorry to hear about your discomfort, Virginia. I mean if that upsets you...since you are married. It's understandable.
I think what you mention about sexual fantasies about being a woman and wanting to dress as a woman are just two points (of many) I haven't considered before... I think crossdressing is profound... I know what it does as a transgender person, to begin to help affirm my identity... I can only imagine what it does for a crossdresser. Sorry this is really going off topic now, but it saddens me that people are ashamed to crossdress. I really wish we would see it daily.

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Thank you AllisonS. I am far enough along in recovery that I have faced the majority of the demons from my past. My struggle now it with the scars they left behind and their affect on my relationship with my wife. Like SeptagonScars and SoupSarah, my therapists no longer see fusion as an option for my System. After nearly 60 years, the five of us learning to work together seems to be as far as my mind is capable of healing.

Quote from: Allison S on September 17, 2018, 03:32:52 PM
wanting to dress as a woman are just two points (of many) I haven't considered before... I think crossdressing is profound... I know what it does as a transgender person, to begin to help affirm my identity... I can only imagine what it does for a crossdresser.

This brings up an important difference between DID and transgenderism. My female alter's gender is NOT an intrinsic part of Self. Flytrap's mannerisms, the way she expresses herself with clothes, makeup and grooming are all part of an elaborate illusion my mind uses to maintain that compartment it created to protect me from the feelings and memories of trauma. Flytrap likes to wear her clothes, but they are not essential to her identity or in anyway affirming of her femaleness. She is as confident and comfortable in who she is whether she is wearing my clothes or hers.

What remains critical for my System at this point in my recovery is the affirmation Flytrap gets that she IS a woman when she is out and about living her life. This illusion of her femininity is vital for maintaining my mind's delusion that she is a separate person. But as I progress in therapy, more and more Flytrap enjoys people seeing her as a guy, the freedom to do things outside of the confines of her femininity, and the break from her self maintenance routine and all the extras that come with looking pretty. And as SeptagonScars has come to see, Flytrap can envision a day she no longer needs anyone's acceptance of her as a girl. And will be able to fully express the parts of Self, feelings and memories she contains as our birth gender of male.