Stop Trying to "Fix" Trans People
Filed by: Guest Blogger
June 21, 2008 10:30 AM

http://www.bilerico.com/2008/06/stop_trying_to_fix_trans_people.php

Editors' note: Matt Kailey is the author of Matt Kailey.jpgJust Add Hormones: An Insider's Guide the Transsexual Experience, the editor of Focus on the Fabulous: Colorado GLBT Voices, and the managing editor of Out Front Colorado, Colorado's oldest and largest GLBT publication.

Trans people aren't broken. We aren't looking to be "fixed," and we have no need of a repairman. We have spent decades trying to convince the Western world of this, and forgive us if some in our ranks were starting to feel a little optimistic about our progress - until, maybe, now.

Just when we thought that an end to the tinkering around with our brains might be in sight - at least for those who are very far sighted - along comes a repairman in the form of Dr. Kenneth Zucker, a non-transman who, like so many before him, thinks he knows what's better for us than we do. Dr. Zucker thinks he can "fix" us - whether we want him to or not.

you don't want to be "fixed"?
so, no more hormones and surgery then?

If you are a cross dresser or other non-medically treated TG then fine, but if you demand a medical solution, you can't be so offended when medical experts investigate alternatives. As a patient you can choose which way you want to be treated, but don't get angry at them for trying to help.

I disagree shoe-horning people into stereotyped gender roles based on biological sex. But i think some psychological approaches could be helpful, especially in milder or borderline cases of GID, like trying to help someone to be a happy feminine male. You shouldn't have such a knee-jerk reaction against psychology.

The difference between treating homosexuals and treating transexuals is that homosexuals don't seek other medical treatment for a perceived bodily problem.

I'm just trying to see it from the psychologists point of view here. I know this post is old, but i see a lot of excess hostility toward mental-health professionals on this site.

^{Sarcasm applied liberally.}

Polarizing article.  Needs more sources and less pigeonholing such as,

"But if the American Psychiatric Association supports Zucker's views, and it must, given his appointment on the DSM task force, then it has only two choices for recourse: put homosexuality back in the DSM or take GID out."

This is flat out wrong.  If this person had read Zucker's research he'd realize that Zucker doesn't pathologize homosexuality nor try to cure it. 

I mean, I understand the push to get this out of the DSM, but using distorted information and fear-mongering will only work for so long before it inevitably backfires.

Oh, and metal angel, I love your post.

BTW, are there any researchers out there currently doing work (on the level of Zucker) with children with GID that disagree with him?  I've been looking but have been unable to find anyone comparable on the other side of the fence.

Quote from: heatherrose on August 26, 2009, 07:43:55 AM

Are you saying there is a "Cure", other than the sufferer
kowtowing to cultural normals and suffering in silence?

Nope.  I only responded after reading what I perceived to be misinformation and fear-mongering on the part of the author of the article.  Zucker might end up being a quack, but at least call him a quack for things he does, not stuff he doesn't.

Well that was my eye-catching headline.

If you read past that, you'd see that i said you shouldn't try to pidgeon-hole people into genders, but maybe a psychological approach would work to make that kid a happy boy who plays with dolls. In fact i think that sex-reassignment pidgeon-holes people into the opposite gender more brutally than even the deamonised Zucker was pidgron-holing their biological gender, and not everyone is 100% happy with the result ()

And I am not suggesting electro-shock therapy etc. Just the milder therapies like talking therapy, to be more comfortable as a feminine male/masculine woman? Some counciling to see if their is a particular need the patient feels may be met by transitioning which may be an unreasonable expectation?

Remember the solutions transexuals are seeking are very drastic. I think they should at least give psychology a chance before they make irriversable changes to their bodies. There will be some cases where the mind can not be soothed without changing the body, and they are candidates for hormones surgery etc. But i think it's wrong to see psychologists as the enemy as a lot of people around here seem to.

and you shold call Zucker a Quack for his specific tactics, forcing kids to conform to the behaviour of a given gender, not just for trying to provide a psychological cure for psychological destress.

---

Post Merge: August 26, 2009, 09:48:05 AM

---

a lot of kinds have transient GID, so jumping into puberty-blockers too quick is at least as damaging... i really should get to bed but i;m going to do a pubmed on this guy and see what he's really up to. My first search shows he's the leader of quite a productive research group... really should go to be though, it's 1am and i have a lab meeting tomorrow.

If they wish to 'fix' us, then just pay for the therapy, HRT and SRS.  Otherwise they can keep their homophobic/transphobic bigoted ignorant opinions to themselves.

Just because I will not conform to their narrow-minded BS views, I need to be fixed.  The only fix I need is SRS.


Janet

Quote from: Janet Lynn on August 26, 2009, 09:14:30 PM
If they wish to 'fix' us, then just pay for the therapy, HRT and SRS.

Actually that's a good point. I don't understand why so many of the people here seem so averse to seeing TS as a medical condition? As a recognised medical condition, wouldn't you have a much easier time accessing surgery for it? I don't know what the current situation is, but if the surgery is required to treat a debilitating psychological condition without an alternative treatment, then you could more easily access funding through public health services such as the UK's NHS, or from health insurance companies etc. If you are not ill then any surgery you want is just a luxury like cosmetic surgery so you are obliged to fund it yourself?

---

Post Merge: August 27, 2009, 05:15:28 AM

---

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

i am reading some of Zucker's stuff now. The guy seems to be "Kenneth J. Zucker" correct? i am having trouble finding much that i can access because it is published in copyright journals which my uni doesn't seem to have subscriptions to, but he does seem to be publishing things with reasonable sounding titles...

I guess the thing i worry about most is the attitude which seems to be taken toward psychologists who assess patients for SRS. The general vibe i get from this community that the psychologist is some sort of gate keeper that you need to tell "the right story" to get what you want. The goal of this is to decide whether someone would benifit from SRS or hormones etc. you should take it seriously and communicate honestly.

---

Post Merge: August 27, 2009, 06:25:33 AM

---

a study on hormonal origin of F2M transexualism by zucker.

http://www.ncbi.nlm.nih.gov/pubmed/18585715?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

I consider my condition medical.

here's a good one, unfortunately i think you'll only be able to get the abstract, but i'll give you a few of the more interesting quotes, i think that's ok for copyright as long as i attribute them, they are from this article:

http://www.ncbi.nlm.nih.gov/pubmed/18321016?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

he does not support a significant connection between GID and homosexuality:

QuoteAlthough there were some modest differences in the mean scale scores (on a questionare measure of GID) between the heterosexual and nonheterosexual men and between the heterosexual and nonheterosexual women, these differences probably lack
any substantive clinical significance.

there is a lot of pretty heavy stats in it but he seems to have an interest in assessing outcomes in patients with GID, intersex people who's gender has been assigned (to see if it was assigned correctly, i.e. in a way they are now happy with), patients who have been biowomen/biomen but had some form of illness or surgery reqquiring removal of sexual organs etc.

here's the follow-up
http://www.ncbi.nlm.nih.gov/pubmed/19396705?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

so far he doesn't seem that mad...

can't find much on proposed treatments though... he seems way more into causes if i have the right guy?

---

Post Merge: August 27, 2009, 05:48:58 AM

---

Quote from: Miniar on August 27, 2009, 06:36:29 AM
I consider my condition medical.

That makes sense. There seem to be a few who object to being regarded as ill, but seem to think that they have a problem which needs a radical action?

Maybe they object to being seen as mentally ill because they see it as a healthy mind in the wrong body? But the body itself is usually physically healthy in every measurable way, but the mind is destressed, so to me it seems that mind is sufferring more? But if the only way to sooth the mind is to alter the body, it seems like they should have that option. Maybe they just feel a stigma with "wrong mind"? I don't understand stigma, i get a desire for privacy (i wouldn't tell my boss about my mental health) but i also feel private about other medical stuff (i wouldn't tell him about my sexual health either).

---

Post Merge: August 27, 2009, 07:01:33 AM

---

http://www.ncbi.nlm.nih.gov/pubmed/17716096?ordinalpos=24&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

in this one he does state a correlation between non-bio-genderred behavious in childhood and future homosexuality, but he says it was less than previously stated and he doesn't seem to be trying to "cure" homosexuality.

If my memory serves me correctly, the DSM says gender reassignment surgery is an effective cure for the dysphoria many of us experience.  I agree that there's a lot of confusion out there, both with the TG and with the "experts" and there's no one stop fix all solution. 

But the main problem most of us encounter is society's attitude toward us.  And when there's a book out there that is accepted by the psychiatry and psychology community as gospel, and that book says you suffer from a "disorder" if you're TG, you can expect to be treated as if you have a mental disorder.

I think the numbers on fully transitioning speak for themselves.  The vast majority of those who transition are much happier than they were before.  I remember reading gender transition was 98% successful.  I wonder how many psychological treatments are that successful?

The facts are clear and they don't lie.  This is a medical condition, not a mental condition.  And the sooner TG is removed from the DSM and recognized as a medical condition, the sooner we can expect insurance companies to start covering our transition costs.  As long as it stays on the DSM, you should only expect your therapy to be covered.

As far as Zucker is concerned, anyone who thinks TG is a mental condition should be eliminated from having anything to do with categorizing it so and treating it as such.

Julie

In most cases (excluding a few intersex cases) the body is perfectly healthy in it's own right? A psychological condition IS recognised as a medical condition, e.g. you can get a disability pension, you can get medicine, often there is some identifiable biological cause.

How would you diagnose GID - to determine who would benifit from hormonal and surgical treatment - if not psychologically?

There are some biological aspects of brain anatomy etc. which are different between men and women and transexuals resemble their prefferred gender in a few of these, but in all cases there is a fair bit of over-lap betwwen biomen and biowomen. It seems unlikely that they will be able to diagnose GID with a brian scan or blood test any time in the near future.

I know you feel YOU know what is right for you, but there are some people who may feel the need to transition, but who may benifit from other treatment. I'll make up an example, what about a gay male who has grown up in a very homophobic community and thinks life will be a lot easier as a woman, he may want to transition as an easy fix, but he proabbly would not benifit from transitioning. You need to diagnose it in order to give treatment to those who will most benifit and re-direct those who will not.

so, given there is no workable biological test, it seems entirely reasonable that there should be guidelines for diagnosing it psychologically.

---

Post Merge: August 27, 2009, 09:24:14 AM

---

A good psychologist uses the GSM as guidelines only, which is as it was intended.

I don't like that the DSM seems to include only pathological conditions and it tends to disregard normal variation. But i think the TG community has more to gain than to loose by having GID in the DSM. Effective diagnostic guidelines will help to inform studies on who can benifit form the sort of treatments you want, which may improve access to them.

I really don't understand why people are so keen to have medical problems rather than psychological ones? My ex boyfriend was bizarely pleased to find his hallucinations were caused by epilepsy rather than skitzophrenia. I can see why he was pleased in finding medications which were more effective, but i don't undertand the pride issue as such.

I guess it maybe dates from the days of huge assylums for the mad? but haven't we moved on from then?

How would you diagnose GID - to determine who would benifit from hormonal and surgical treatment - if not psychologically?

Well, to date, the only way of doing it - the diagnoses - is the word of the patient that they have it. It is - and almost unique in this - about the only thing condition that is 100% self-diagnosed. Which does lead to problems in some ways.

How would you diagnose homosexuality?  The individual says they are gay.

Now, if you want to take that further and say they engage in homosexual activities, then you need to do the same for the TG and acknowledge TGs engage in transgender activities.  It then becomes more than just taking the person's word.

How would you diagnose homosexuality?  The individual says they are gay.

No, there are certain thoughts and behaviors that pretty well mark it. And no one is really trying to fix gay people - outside of a few oddballs - so its a self defined sexual preference, not a DSM category.

Quote from: juliekins on August 27, 2009, 02:02:10 PM
How would you diagnose homosexuality?  The individual says they are gay.

There's no real medical need to diagnose homosexuality. In most medical litrature (e.g. guidelines for screaning for STDs) they tend to use terms like "men who have sex with men", the treatment is just judged be behaviour, psychology aren't really that essential for providing appropriate treatment. STD risk and any other health-relevant risks are pretty much the same for someone who displays that behavious whether they are gay, bi, or just experimenting.

But if you are going to provide drastic medical treatment (gender reassignment) you need to do a deeper exploration to determine whether they will benifit from this treatment. e.g. a lot of crossdressers would not need or benifit from gender reassignment.

---

Post Merge: August 27, 2009, 05:48:15 PM

---

There's no real way to "diagnose" homosexuality, if they are conducting research there are tools to define it (most often refrenced at Kinsey 1948) but there is no real need to asses a clinical patient (i.e. outside of a research project) so i guess that's why homorsexuality is not in the DSM.

I think maybe homosexuality should be described in the DSM with some kind of headder marked "normal variation", it may be useful to provide some information on normal behaviour for if someone scomes in needing treatment (e.g. for depression) but also is unusual in a non-opathological way the psychologist is unfamiliar with (e.g. homosexuality).

but i guess the cut-off is whether theree's a medical need to ever "diagnose" the condition in a patient.