Gatekeeping The Gender Binary: A Good Policy?
Posted August 13, 2008

http://radnichole.wordpress.com/2008/08/13/gatekeeping-the-gender-binary-a-good-policy/

Should mental health professionals be in the business of gatekeeping clients desiring a sex-change?

Having worked as one, I have to say 'no.' It's a somewhat qualified 'no' though. Maybe I should ask if transitioners should obtain therapy before going into transition? For that I would answer 'yes.' Simply because I think that working with a good therapist can be good for most of us human beings. My best friend, who lives in Nashville, is a psychiatric nurse, has been for thirty years. She's fond of saying that "two weeks of therapy a year should be required for all well-adjusted people. Of course the really crazy ones cannot help but get it."

I agree, the 'gate-keeper' deal has had its day.  Perhaps it was a good idea once upon a time, but those days have come and gone.  Informed consent is the way to go.  You pay your money, and you take your chances.  People can't be protected from making bad decisions for themselves.  So if it does not work out well for everyone, well, what does?

Whay I only glancingly covered in that essay, Kat, is that I think that the entire gatekeeping process was a way that cissexuals used to make the entire train of "sex-changing" more easy for cissexuals to handle themselves.

They needed to somehow OK the feelings, drives and beings of transsexual people to somehow legitimate us. I think many of the gatekeepers have this "default" notion that we are very legitimately "crazy," simply because they have no dysphoria like this one of their own.

I think there is some evidence of that in the fashions in which in the early days women (men were not even an after-thought at the time) were encouraged, cajoled and in some places basically threatened with terrible repercussions that denied them ever being able to allow the world to come to terms with us.

I think there was an inherent shame imposed through the gender-clinics and many practitioners that has carried over in some very distinct ways into the present.

So very much of psychiatry and therpay is very often an attempt to "normalize" the patient. That a patient might be "normal" rather than crazed is hardly ever considered, at least not in my experience. Diagnoses are "passed on" from an original practitioner to anther and another and the person basically becomes the so-called illness.

At the same time the goal of many practitioners appears to be a sort of "norm-enforcement" of the prevailing society. What we don't like or don't think "proper" is often pathologized and made an "illness."

That conditions like schizophrenia, schizo-affective disorders, mania, depression and bi-polar exist as well as some personality disorders that are the deeply-conditioned roots of social ills: like the sexual abuse of children and young men and women, physical trauma and emotional devastation is unquestionable.

Yet, Borderline, for instance, and Anti-social PDs, simply because they have become such consistent baskets into which people who are difficult for others to deal with, are often mis-diagnosed and even more often treated ineffectively because they require a lot of time effort and understanding on the part of the practitioner.

I think therapy can be a very helpful tool for almost any person who lives within a distinct and ostracised minority. But the treatment will not work if it is merely an attempt to convince the person they should be different than they are. We have often taken genuine and distinct human genotypes and attempted to force them to conform to the dominant culture. That, imo, is not therapy, its tantamount to a psychic ethnic-cleansing.

It's gotta go.

Nichole

I would imagine that in the beginning such 'hoops' were serving a two fold process.  First, and foremost, they protected the professionals from lawsuits.  The gatekeepers were liability blockers more than anything else.  Second, Harry B and the rest of the early people were looking for a way to make it an acceptable medical process, and to that end they needed a 'pathology' for the diagnosis and a 'protocol' for dealing with it. So they created one.


therpay - great typo

I would imagine you are right, except that the SOC wasn't made by Harry. It was made by others. Harry actually appeared to find it a reasonably "normal" condition. But, yes, you are also right about the establishment of guidelines to encourage a medical treatment model, not to be mistaken for medical treatment.

A medical treatment model simply labels what is being treated as an illness. Transsexuality, and I suspect most gender issues, is not an illness at all. It does appear to be a human variation, normal as ... o, say brown skin or blonde hair or various skull types of various human beings. Is hair color or skin tone and texture a birth defect or an illness that should be pathologized?

And no, Kat, I want to hear absolutely NO blonde jokes!! Nor do I wish to read any either! 

N~   

a medical treatment model, not to be mistaken for medical treatment

I would never do that, I know only too well how far apart the two are in reality sometimes.

And no blonde jokes, too bad, I know some real good ones.  Its almost a religion out here.

Quote from: tekla on August 13, 2008, 03:58:34 PM
a medical treatment model, not to be mistaken for medical treatment

I would never do that, I know only too well how far apart the two are in reality sometimes.

And no blonde jokes, too bad, I know some real good ones.  Its almost a religion out here.

Yeah, that just soooo figures!!! And count on you to be the major source? *smirk*

And I'm supposed to trust you to get me a decent bike if I visit SF?

N~

Hey, what can I say?  I work with a lot of comedy stuff, and go see it on a regular basis, and Cali is the worlds largest source of blondes outside of Scandinavia.  So you paint what you see and all that.

And bikes I know. 

so......


A blonde cop stops blonde motorist and asks for her driving license.

The motorist scuffles around in her purse and can't find it. She says to the cop, "I must have left it at home officer."

The cop says, "Well, do you have any kind of identification?" The motorist scuffles around in her purse again, and finds a pocket mirror.

She looks at it and says to the cop, "All I have is this picture of myself." The cop says, "Let me see it, then." So the blonde motorist gives the mirror to the blonde cop, who looks at it, and replies, "Well, if I had known you were a police officer, I wouldn't have even pulled you over. You can go now."

Tee-hee. One of these days, tekla, one of these days!!! TO THE MOON!!

When Keith Moon died he woke up and
found himself on a stage with instruments all set up.
A door offstage opens and in walk Jimi Hendrix, Jim Morrison,
Brian Jones, John Lennon, Otis Redding, and Buddy Holly.
Each musician picks up his favorite instrument and begins tuning up.
All of the instruments are taken but, to Keith's immense pleasure, the drums.
He walks up to Jimi and says, "Man, so this is what heaven is like."
Jimi looks at him and says, "Heaven? You think this is heaven?"
At that moment, Karen Carpenter walks in, takes her seat
behind the drums, and calls out, "Okay guys, 'Close to You'.
One, two, three, four..."

QuoteIt does appear to be a human variation, normal as ... o, say brown skin or blonde hair or various skull types of various human beings. Is hair color or skin tone and texture a birth defect or an illness that should be pathologized?

The reductionist and determinism might declare that but there is not enough genes to make the details of one's brain do certain behavior. It has an element of personal choice. The best we can say about the biological is that it plays with the probabilities.

There are a lot of people who would disagree with the element of personal choice deal.  Time will answer that issue perhaps, but its up for debate.

Read "Blank Slate".  Then again you are of the West Pole. The East Pole has a different view.

Quote from: tekla on August 13, 2008, 04:50:19 PM
At that moment, Karen Carpenter walks in, takes her seat
behind the drums, and calls out, "Okay guys, 'Close to You'.
One, two, three, four..."
[/i]

Ba doom... crash 

Nichole, I thought this was an excellent and important article!

Many years ago I worked with a very good gender therapist, however because I was acutely aware of the gatekeeper aspect of the relationship and its inherent power dynamic, it took quite a while before I really got past that baggage to fully trust her.

My belief is that what we now call transgender/transsexuality has existed throughout human history, it is a natural variation. The only illness/pathology I see is societal intolerance of our genders... Can we find a cure for that? Soon! Please!

Zythyra

Well I'm aware that the position that its a choice is held by the more conservative elements including the Christian right.  If its true, then there should be no coverage for it, no civil rights either, because its a choice, and all that other stuff is just cosmetic.  I'm not sure that argument is going to find a lot of support here.

There does seem to be a lot of historical examples of it, but the historical examples do not argue for or against it being a choice or a natural type of difference.

Quote from: tekla on August 13, 2008, 05:29:47 PM
Well I'm aware that the position that its a choice is held by the more conservative elements including the Christian right.  If its true, then there should be no coverage for it, no civil rights either, because its a choice, and all that other stuff is just cosmetic.  I'm not sure that argument is going to find a lot of support here.

Regardless of whether it's a choice or not, there is no legitimate reason for discrimination. After all, isn't Christianity or any other religion a choice as well?  >

Z

Quote from: lisagurl on August 13, 2008, 04:56:36 PM

QuoteIt does appear to be a human variation, normal as ... o, say brown skin or blonde hair or various skull types of various human beings. Is hair color or skin tone and texture a birth defect or an illness that should be pathologized?

The reductionist and determinism might declare that but there is not enough genes to make the details of one's brain do certain behavior. It has an element of personal choice. The best we can say about the biological is that it plays with the probabilities.

Ya think? What about other way around -- personal choice plays with probabilities? One may be born with hair or skin color and texture, a particular shape of skull. In society one, on continent 1 that person is a dominant -- part of a majority of inhabitants.

On Continent 2 another skin, hair, skull configuration is dominant.

Yet on both continents variation allows that certain individuals of the other type exist as well. These people remain subservient on that particular continent. They are held in low esteem and always have menial jobs.

They may choose to rebel; they may choose suicide; they may choose subservience; they may choose to emigrate to the other continent, if they should discover it exists. They may not choose to become dominants by changing the configurations of their hair-color, eye-color or skull shapes. Their birth lot is a subservient position in the culture they are born into.

I'm sure that you are an avid proponent of free-will. However, in that case there will be certain natural & historic and cultural characteristics that will limit the choices either set of subservients. Free-will will only occur within certain confines limited by nature and circumstance.

The same thing holds true in all of our lives. The sexual variant might well choose not to transition, she or he might choose to commit suicide or he or she might choose to transition or to transition part-way. That I will not argue with, Lisa. But the choices are going to be limited by what is possible within a larger context.

That may violate your philosophical sense of "the way things are." But there are circumstances that we may not like and may not agree with our philosophies that willbe factual and simply given. I cannot change the fact I was born transsexual. I am able to change the ways I have to cope with that fact. Period.

That it doesn't fit some Randian thought dogma is no concern of the reality of the situation. The dogma must change to fit the reality. Not other way around.

Quote from: lisagurl on August 13, 2008, 05:11:49 PM
Read "Blank Slate".  Then again you are of the West Pole. The East Pole has a different view.

No matter which pole one lives under: facts of human being remain true north, south, east, west. And alas, "there are wonders you never touch in all of your philosophy." Mainly, imo, because our philosophies consistently make an attaempt to violate what is truly there.

Nichole

If gender is a continuum due to interaction of plenty of genes, and
its expression is influenced by environmental factors (like parents and society)
which work in a probabilistic manner with those genetic influence.

There is no determinism.

Is someone who lived 50 year as hetero and maries,
then "becomes" gay, truly gay, was he really hiding from himself, or
just gay at that moment in their lives. Or Somewhere in between
gay and hetero, which expresses itself according to the environment.

In the gender is not a binary and expresses in a multifactorial way,
then, for those not in the extremes, there could be a choice of
how it shows up.