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Need some help with a paper.

Started by Tad, November 23, 2010, 08:24:51 PM

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Tad

Being a 4th year psych student, I've taken to writing my papers on Transexualism and other queer issues.

Currently I'm writing on the fact that studies have pointed to a certain region in the brain that appears to differentiate between the genders (with transexuals regions aligning with that of their percieved gender)

At one point in my paper, I am wanting to discuss therapy and ex-trans type programs. When talking with trans people/here on the forums, I have interacted with many individuals who have tried these therapies and found them not to work at all. THat it maybe drove them underground - so perhaps appeared to work. But the treatments did not work in the long term. However, I have not been able to find even one study that mentiones the inefectivity of gender therapies that seek to allign ones gender with their biological sex. Some more recent studies have admitted that the old way of humiliation and outright trying to change an individuals gender fail horribly. But that, allowing the individual to learn to be more comfortable with themselves as an individual, allowing and even encouraging corss gender activities, and taking the stygma away from acting against the norms of ones gender: the people who go through these therapies lose their transexual urges and become comfortable with their biological sex (though with an 80% homosexuality rate). True, most of these studies address children, and it's true that many children outgrow gender identity issues anyhow.

I guess what I'm trying to say.. does anyone have any links or knowledges of studies.. where in the end - transexualism, SRS, hormone treatments is the only effective outcome for adults?



Guess all this research has me questioning too. After reading paper after paper after paper published from all over.. and discounting all the old 70's and 80's crap.. and looking strictly at studies published in the late 90's and 00's... it still seems to be that gender change therapy is often very effective, often working within 4 months to 2 years. And as much as I identify as male.. what if it is possible to go through this kind of therapy.. and be happy with my biological sex.. and save myself from half a dozen surgeries...  Has anyone ernestly tried this kind of therapy more recently.. not the old style of forcing you to conform to expected gender roles.. but more teaching you just to be accepting of what nature has given you?
  •  

Flan

from '99 (Transsexualism: A review of etiology, diagnosis and treatment)
http://www.shb-info.org/sitebuildercontent/sitebuilderfiles/articulogoorenkettenis99.pdf

from 2007 (Continuing Medical Education: Gender Identity Disorders: Diagnostic and Surgical Aspects)
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2007.00580.x/full
a bit focused on surgery, but notes on patient management, i'll upload the pdf on request

sorry for not finding much more :|

edit:
2009 (Ethics of Gender Identity Disorder)
http://www.ingentaconnect.com/content/springer/ehpp/2009/00000011/00000003/art00003

2008 (Handbook of sexual and gender identity disorders)
http://books.google.com/books?hl=en&lr=&id=1stVkph8Ay8C&oi=fnd&pg=PA423
Soft kitty, warm kitty, little ball of fur. Happy kitty, sleepy kitty, purr, purr, purr.
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Tad

Thanks Flan.. I'll take a look after Glee tonight.

I'm just kind of frusterated.. after browsing through perhaps a hundred papers on the topic.. not one.. suggests that actual transition is the key for GID..

If all the scientists and therapists that are publishing are saying no to transitioning.. then why is transitioning becoming a more common treatment.. and where is all the infromation on generic web pages coming from (that conveniently never provide references)....

And of course.. this is causing me to question full out transitiong in myself lolz.. because these new styles of therapies seem to have great results... however all of the new styles also seem to be performed on children.. who are still a bit more impressionable? I donno. I'm a male, I want my ormones and my surgeries.. I don't particularily want to change who I am, I am confident and comfortable with my dentity. But.. I dont think I should discount at least.. asking and learning a bit about these other styles of therapies as well. Information leads to a more informed decision. I like to investigate all avenues, even though I'm fairly set on starting the mones soon.

Oh if anyone's interested.. I can also download and send out PDF's. I'd link - but since I have access to all the restricted usage sites - none of you would have access to these articles. :(

  •  

Sean

My understanding - and I've read this in numerous places - is that improvements after starting Hrt is considered to be a confirming aspect of the GID diagnosis. Namely, that people who are indeed transsexual not only benefit from transitioning, but rather, the fact that transitioning 'works' for them - in terms of HRT easing feelings of dysphoria - demonstrates the validity of their diagnosis.

What this means is that you might have stumbled upon the question-begging aspect that is so often present in mental health diagnosis and treatment. What makes someone a transsexual or have GID in the first place? Or in other words, how do you know that the people who are getting the therapy to help them cope and adjust to not transitioning are actually transsexual or have GID in the first place? That's especially problematic, to the extent it becomes a No True Scotsman issue. If the definition is "No true transsexual can deal with not transitioning..." well, then, that's not very helpful or useful as a scienfitic matter. You and I may not be very body dysmorphic. Someone else might be. In another era, neither of us would even COUNT as transsexual.

Unfortunately, part of the problem the trans community has faced is that for years, the medical establishment defined what made a "True Transsexual" in a way that we now know is wrong (e.g., I'm gay, therefore, they would say I wasn't a man - except, I am, and I exist) and it further encouraged people to lie to health care practitioners to give them the narrative that was understood to get access to health care. I'd be shocked if you could find any psych study that is older than about a decade that is not wholly contaminated by this circular problem of trans people responding in the way they think doctors and researchers want them to, causing doctors and researchers to understand transsexuality in a particular way that they themselves steered it. 

I'm not sure what studies you are looking at and from what disciplines. It seems pretty well settled that there is such a thing as GID and that it stems in the brain, though it's origins/causes are murky. There also are studies indicating the success rate of transitioning as a 'treatment' for GID and indicating which factors are likely to lead to better or worse outcomes.

If all you are finding are studies saying, "People can choose not to transition and learn to change their gender" - that seems patently false, based on the research I've looked at (we can move this to pm if you like - I do have access to databases). If what you are finding is, "People can choose not to transition and learn to cope with a physiology that doesn't match their gender," then I'd like to see the data on that. Best as I know, no one has good scientific data on that (namely because the *missing data* - those who never see doctors or therapists or anyone, who chooses these programs & how do we evaluate what it means to cope/succeed, isn't available).

If what you are finding is about youth, then it's not really relevant (it seems to be accepted that gender identity is either not fixed or cannot be determined prior to puberty).

As someone whose tendencies are to intellectualize everything, I know what it's like to look at data and studies and do research and try to get a picture from the greater whole to extrapolate onto myself, make decisions or even define myself. I didn't even think I WAS trans, even as I was extensively researching the subject, because I didn't match the descriptions or definitions I was reading. Eventually, I had to grapple with how I feel and how I interact with the world, and while I still rely heavily on research and studies in making informed choices about my health care, I also have learned to separate myself as an individual from an aggregated whole. I wasn't going to figure out what decisions were right for me or could help me by reading studies or even finding the best meta-analysis. I was only going to get there by looking inside myself, having quality health care providers, talking to my spouse and other supportive friends, and so on.

I think it's good that you are researching, and I think it's good that you are questioning what is right for you. There is no one right way to transition and there are different options for everyone in how you choose to express your gender (which is not the same as what your gender idendity is). Surgery may or may not be for you. I think any good gender therapist would want to see if you can first be happy being male and not having surgery and work with you on this idea. I know it's something my therapist talks about. So I'm not sure that you'll find studies looking at how many transsexuals really are happy going non-op or no surgery after trying it, because it's just something that's not data being collected in that way. But for your own personal experience, you can see how it works.
In Soviet Russa, Zero Divides by You!
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Tad

Naw.. I'm all for the surgeries.. just the questioning that some of these studies show on successfully re-programming gender. If I could be happy as a female.. is that a worth while option to look into?


Anyhow. not what this was about. I more just need articles that are actually showing that transitioning is the best option. Flan, I liked one of your articles.. other ones weren't quite relevent to this current paper, however I'll save them for future writings.
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spacial

I found these to add. http://www.religioustolerance.org/transsexu9.htm

http://www.education.com/reference/article/biological-sex-gender-identity-children/

I can't. sadly, find any references at the moment, but I'm pretty sure that, prior to recognising GID as being treateable with surgical intervention, it was genrally treated as a psychosis, specifically, a variant of schizophernia.

The arguement for this diagnosis is that the notion, that ones biologcal sex diesn't match their expectations, has no basis in, evidence, cultural or social background, it is unresponsive to reason and is therefore a dilusion.

The established approach to any dilusion is not to reinforce it.

However, GID is generally not accompanied by any other significant symptoms. Many people with GID do self harm, they are frequently socially isolated, economically incompetant, depressed.

However, it has been demonstrated that all of these symptoms are usually associated with the GID, therefore reactive. Further that none of these other symptoms responds to any sort of viable treatment while the GID remains.

As far as I know, GID doesn't respond to any of the standard thrapies, aversion, cognitive, positive reinforcement and so on.

This is not a satisfactory situation for a diagnosis of schizophernia. More over, once the social isolation and ecomonic incompetance are removed, since they are a consequence of the GID symptom, there are no schizoid type symptoms, other than GID. A single symptom is not, in itself sufficient for a schizopernia diagnosis.

Since you are in higher education you will presumably have better access to medical and psychiatric texts that i or most others.

What you should search for however are sexual disorders. Disorders of sexual development. Disorderers of sexual function. Homosexual fetishes. And so on.

As you will probably know, accessing old research os often quite difficult, especially when it has been discreditied. This is generally, in my experience, to reduce the opportunities to launch legal action.

Note to anyone else. The terms I've used here may seem blunt, or even harsh. But these are the sort of terms that were and are commonly used in this branch of medicine.

GID is an unexplained disorder that seems to respond well to surgical intervention.
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Tad

GID isn't completely unexplained though. New autotspy research shows significant evidence in various regions of the brain that points to a physical home of gender.

Actually I should be more specific.
I NEED papers that discredit therapy as a form of treatment that works well.. Therapy such as ex-gay, changing gender identity etc. I wasn't clear on that before. This is what i cannot find. I can find papers that say transitioning is right in certain circumstances.. but I cannot find papers that discredit gender reassignment therapies and whatnot.. making people feel comfortable in the sex they are born.

There has to be relevent research here that discredits this.. because I've met many ->-bleeped-<-s who say this therapy does not work. They've been through it and it was utter failures. I want this data, but in empirical or review article form.. :(


Any directions on those kinda papers would be helpful. Right now I feel lke I'm writing a losing battle on my paper. (Topic - GID does not belong in the DSM).


Oh yes; articles performed on children and people under the age of 20ish are also irrevelant. As most cases of childhood GID do clear up on their own by the end of puberty.

With the thousands of studies out there on trans I thought perhaps I could find articles that backed up the general opinion that gender/ex gay type therapy is an utter failure in true transsexual cases.

Ima keep looking.





Note: spacial, up to 30% of schizophrenics will present with some kind of gender disturbance at some point. Hence it is still very relavent to be sorting out the schizos from the trans. And since Schizo's have a 1% prevalence rate... I can see why this can be an issue... if.. 1 out of every 300 people in the general population is coming in with GID symptoms because they are having a particular schizophrenic episode.. the true cases of transsexualism which are thought to be much rarer - need to be sorted out very carefully. From my understanding in certain case studies - that's why the 1-2 year wait on hormones used to be mandatory - because the gender issues in schizo's would clear up within that time period, whereas they wouldn't with a true trans. At least that's the impression given by some of the older researchers and clinicians.
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Flan

another one, seems to dwell on the self diagnosis/treatment aspect, at least that's the impression i get

2006 (Changing Race, Changing Sex: The Ethics of Self-Transformation)
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9833.2006.00332.x/abstract

edit: on second thought, this isn't all that useful
Soft kitty, warm kitty, little ball of fur. Happy kitty, sleepy kitty, purr, purr, purr.
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Arch

Tad, you might try Zoe Brain's blog. Or even send her an e-mail. If she doesn't know, she might have some useful ideas. But it's possible that you'll only find anecdotal evidence rather than research results. (I know, not much help.)

Keep us informed, will you? This is interesting.
"The hammer is my penis." --Captain Hammer

"When all you have is a hammer . . ." --Anonymous carpenter
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Tad

Will do. So far most of the research is either old.. DR money approach. 95% of the trans articles appear to be 1980's or older. The newer stuff is mostly focused either on satisfaction of surgery results.. or on brainwashing children - well I donno if it's brainwashing when it has a 100% success rate.

Gah.. running out of time. Only 6 more days to find the kind of papers I'm looking for.


I'm having fun writing trans papers.. I wrote one a few months ago on how to work as a counsellor for transpersons- and got top marks.

This one is on the origins of gender identity and whether or not GID should be included in the next DSM.


My next one is on sexual orientation and gender identity worth 100% of my mark o_O

Got a full courseload of trans related papers this semester.. XD
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spacial

Tad.

I do understand about the need for specific papers. But I suggest you might have better luck finding them by changing your search parameters.

As I said, medics tend to be a little reluctant to admit past mistakes.

I also feel that the emphasis upon schizophernia is frequently overstated. Many of us have various schizoid symptoms, but the modern emphasis is upon function. The presence of some symptoms associated with schizophernia are not, in themselves, sufficient to deny individuals the competance to make decisions.

Social isolation, for example, is recognised as a schizoid symptom. The feature itself, is often termed schizoid personality type. But speaking as someone who is very socially isolated, I function perfectly well. In social situations I do become increasingly uncomfortable, even to the point of losing some control of function. The solution is to avoid these situations. Indeed, many who habitually use alcohol or other mind altering substances, in social situations, are probably experienceing the same schizoid symptom. (I don't use any substances, personally)

If we look at one of the standard claims about transgender, for example. Woman, trapped in a man's body, (or the opposite). This is clearly a dilusional statement. But is it dilusional because the person genuinely believes they are a woman, and their outward apparance is little more than an inappropriate coat? Or is it simply a notion? If it is the former, has it resulted from personal commitment, or an actual distortion of the cognitive thinking process?

I strongly suggest you are very careful putting too much emphasis upon post mortum examinations of brain structure, or even EEG examinations of those claiming to be transgender. Any such evidence is selective, at best.

Similar claims have been made about homosexual people. (On this point, you may wish to look a little more carefully at the history of general acceptance of homosexuals. You may be surprised to discover the time line became very busy around the same time as President Clinton was elected, with a mandate to allow gay people into the US military).

Schizophernia is a complicated set of conditions. They could even be seen as forming a personality type, as is now recognised in most parts of the world, (I think, excluding the US), in the case of psychopathy.

What I'm trying to say to you Tad is to look at some past papers on schizophernia. Papers, approved for reference, should be available in your college library.

Most will tend to cover extreme cases. As someone who spent a number of years, working as a Registered Nurse, in psychiatric hospitals, I can say that a small minority of people with schizophernia, do indeed suffer quite extreme symptoms.

But you need to concentrate upon people who suffer mild symptoms, mainly those treated as out patients in the community.

If you want any sort of positive direction, may I suggest you treat all medical evidence as backup to the more impotant issue. That each of us, has an absolute right, to live as we choose. Attempting to demonstrate any rationale of transgender, based upon medicine is, at best, open for debate and perspective. At worst, the actual evidence simply doesn't exist.

edit, added a clrifying word to the statement: The feature itself, is termed schizoid personality type. Without this, the statement isn't actually true!!!
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Tad

I'm not actually covering schizoid or schizophrenia at all in this paper. There is no need to. I only brought it up because you did.

The topic is simply - should GID be in the DSM - since the big debate right now is to whether or not it should be considered a mental disorder or not.

This debate resolves around the fact that to get diagnosed by the DSM - your condition - whatever it must be - must cause you clinical distress.

It's is debated that GID does not fit this at all. Because - this clinical distress must come from within - and not from society. Many GID people suffer distress because they are responding to how society treats them, wrong pronouns, fear of violence, etc. These are all real things to be distressed over, and they are not internal conflict - but rather rational fears (for the situation).. that are provoked by society. Since many physicians consider that yes, GID conflict is not from within - but that most of the distress is caused by society - GID cannot fit a DSM diagnosis.

Having to fit within the parameters of my paper writing I must include 1 main empirical article - on which I've chosen autopsys? Why? The results are golden. They are not pointing to TG as freaks.. but that transwomens interstitial nucleus of the anterior hypothalamus are the same size and density as bio females, that the transmale's fit right into the normal male range. Further they compared with different groups such as castrated men, pre and post menopausal women - to see if androgens or e was playing into the size - ie.. people on e would have the female sized region and T would have the male size. The one transmale hadn't been on androgens for years and his was still within male range versus the castrated men - who hadn't had T for years, their regions had shriveled a little, but were no where near female regions either. There seems to be very set differences in these regions. There are many other studies that can point to the gender differences in this region and other studies of autopsied transexuals that will also verify this as well.

I know.. many people don't want to have any physical cause behind TS/GID... they just want to be able to be accepted for who they are. People fear that if there is a physical region found.. and that somehow a test came out to test for TGness... people who failed the test wouldn't get the treatment they need. However.. a test isn't likely to come around anytime soon - right now they can only look at these sizes once you are dead. Secondly.. just like scizophrenia... TGness is loikely to be caused by a variety of factors - not just one specific area. So while these particular studies might help confirm that there is actually something to scientifically back up TS, it's not the be all end all.

I am also covering Dr Money in my paper - as his failed experiments are another clear pointer to GID having a physical root versus a social identity.

It is important for these studies... because if you really went out and talked to people in your community.. many of them still believe that TS is a choice, and that Gender Identity is completely socially programmed. Hell, you'll find doctors that believe that too.



And spacial I cannot focus on the right for TG's - this has to be a scientific paper. None of that rights stuff. Everything has to have a scientific, experimental basis for me to get any marks on this at all.  Hence my need for a few empirical articles that talk about the failure of psychotherapies in reprogramming gender. (Aside from Dr Money.. bahahahaa) I've gotten everything else covered.. except for the fact that I am having difficulties finding these papers.. so perhaps I should just cut that out of my paper altogether.
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spacial

I'm sorry Tad, I did get somewhat off topic there.

I know very little about the DSM. Best of luck.
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lilacwoman

PubMed is the best place for uptodate info from both professsional therapists and researchers who live in the modern world...they also give space to the stupidities of Blanchard and Bailey et al.

http://www.ncbi.nlm.nih.gov/pubmed
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Tad

yeah I use pubmed.. it's incorporated into my greater search engine that scans a multitude of resources like pubmed.
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Arch

When you search for sources, do you search only for the word "transsexual" in it and then read every title/abstract that pops up, or do you use a stricter search criterion? Back when I was doing similar (interest-driven) research back in the mid-nineties, things were a little different. We didn't have absolutely everything in databases, and there was far less research out there to begin with. So I could actually troll through every single article I found with "transsexual" in the title.

If you haven't already, and if your database doesn't automatically suggest such variations, you might try "transexual" with one "s."
"The hammer is my penis." --Captain Hammer

"When all you have is a hammer . . ." --Anonymous carpenter
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jmaxley

Here's something I found, you may have seen this already though.

Does Reparative Therapy Cure Gender Dysphoria?
http://home.surewest.net/drmilazzo/francie/therapy.html

Looks like some interesting articles in the footnotes but some of the links were dead.





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Amazon D

I think there needs to be new studies to determine how people might change their minds to transitioning depending on age
and wether they are use to getting what they want or are they just using transitioning to try to solve another problem they never dealt with.

There is also societies boxes people are put into which has many feeling they have to fully transition.

There are also sites like these that many times promote transitioning where none is needed.

There are way too many factors never addressed in transitioning.

(so called) Gay males who transition verses (so called) hetero males who transition and what are their reasons for feeling they need to be a certain gender to either fit in or to justify their having intimacy with the previous same sex now the opposite sex / men.

There are also those who transition who do it not for intimacy but to actually get away from intimacy.

There are those who do it for sexual reasons alone or for money and power.

The factors are so varied.

These are the studies that need to be done because it isn't a black or white option (AS IT IS STUDIED ) and it shouldn't be.

I do know for myself it was the best thing for me at the time and my life would have become a living hell had i not done it.



A RECENT POST OF MINE THAT MIGHT GIVE YOU A BETTER UNDERSTANDING OF ME:


Quote from: Devyn on November 24, 2010, 08:00:44 pm
Wait, wait, wait. You're a post-op MtF, but a non-op FtM? That's quite interesting.

yes kinda ironic huh  I basically love being able to let my mind control my body sexually not the other way around as before i transitioned. That is opposite of what most non trans people think about us too. I did have all my facial hair removed so i can't grow a beard and so most people see me as a FTM (or know me legally as a Female) and i get lots of positive support verses when i was living the other direction. Then i was being harrassed by prejudice people if they found out or getting unwanted attention from men who did or didn't know. So yes to me life is half how i feel about my own sexuality and half how others perceive me that has me living as a non op FTM. Now i can be my best and experience the best from others. Life is about living in the world and we do have to deal with other people so might as well get that which you want not that which you don't want. I have seen many people limit themselves to a certain geographical location to exist with some semblence of peace. I have found there isn't any place i can live now and feel uncomfortable. No longer do i need be on one side sticking up for myself against others who may be against me. That was wasting too much energy and not allowing myself the freedom to just live and move on as most people do. I tried the activist route and found i was living in a constant fight with someone or the other. Life is too short to spend it with people who's ideologies may or may not agree with me. Mostly all people want to just fit in and move on with life. Being an activist can be a lonely way of life limiting oneself to a attitude of having people against you for the sake of an attitude of forcing ones beliefs on others when in reality we can never get them to change.

There is a song:

I went to a garden party to reminisce with my old friends
A chance to share old memories and play our songs again
When I got to the garden party, they all knew my name
No one recognized me, I didn't look the same

CHORUS
But it's all right now, I learned my lesson well.
You see, ya can't please everyone, so ya got to please yourself

People came from miles around, everyone was there
Yoko brought her walrus, there was magic in the air
'n' over in the corner, much to my surprise
Mr. Hughes hid in Dylan's shoes wearing his disguise

CHORUS

lott-in-dah-dah-dah, lot-in-dah-dah-dah

Played them all the old songs, thought that's why they came
No one heard the music, we didn't look the same
I said hello to "Mary Lou", she belongs to me
When I sang a song about a honky-tonk, it was time to leave

CHORUS

lot-dah-dah-dah (lot-dah-dah-dah)
lot-in-dah-dah-dah

Someone opened up a closet door and out stepped Johnny B. Goode
Playing guitar like a-ringin' a bell and lookin' like he should
If you gotta play at garden parties, I wish you a lotta luck
But if memories were all I sang, I rather drive a truck

CHORUS

lot-dah-dah-dah (lot-dah-dah-dah)
lot-in-dah-dah-dah

'n' it's all right now, learned my lesson well
You see, ya can't please everyone, so you got to please yourself


I'm an Amazon womyn + very butch + respecting MWMF since 1999 unless invited. + I AM A HIPPIE

  •  

lilacwoman

all the personal experiences and research I've had including time as LGBT delegate for work lets me know that there are a lot of men who crossdress but very few who are genuinely transsexual enough to be able to live fulltime.  Lots of non-transexual women crossdress completely and get topjobs without being transsexual.
That's why I think in countries with a National Health Service RLE is essential as without it any CDing male or female can progress through surgery and then regret it.
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