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TechnoratiFocus on gender politics: Is changing gender as simple as changing clothes?
Newsweek recently painted a sympathetic portrait of women imprisoned in men's bodies. Such people need a psychiatrist, not a surgeon.
Political correctness is not only contrary to the spirit of the First Amendment of the American Constitution but also makes for soporific discourse. Newsweek’s recent cover story on transgenders certainly proves that the priests of tolerance and diversity have successfully exorcised the ghost of satirist H.L. Menken from the mainstream media. Newsweek’s coverage was so saccharine that I needed wet wipes after each page.
An issue involving sex and castration should generate a lot of hotly disputed questions. Unhappily, Newsweek relegated any dispute to the usual evangelical bogeyman, with mild scepticism replacing controversy. After all, it averred, we can’t really know the difference between men and women, or male and female. Even the experts at the International Olympic Committee plead ignorance, it was claimed, when it comes to "scientifically" differentiating between a man and a woman. (If East Germany still existed I guess that its athletes could get their medals back!)
At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can't be reassigned.
Newsweek also avoided the other key debate about this difficult issue: whether or not transgenders have a mental illness or merely an inconsequential desire. The word "transgender" is a neologism coined by activists to denote people who at least sometimes identify themselves with the opposite sex. Typically, these folks are transsexuals and/or transvestites. Both transsexuals and transvestites have been in the psychiatric "Diagnostic and Statistical Manual of Mental Disorders" (DSM). Transvestitism is intense sexual arousal to women’s clothing. Transsexuals identify themselves as the opposite sex. In 1980, transsexualism was added to the third edition of DSM. In 1994, the term "gender identity disorder" replaced transsexualism.
Doctors get involved because transsexuals often demand hormones and surgery to fulfill their desires. But are physicians enabling a mental illness or merely complying with a cosmetic request?
Many transgender activists object to the "crazy" label. The brother/sister of actors, Rosanna, David and Patricia Arquette was featured in Newsweek. Alexis Arquette is on a crusade against current standards of care. He/she complains that sceptics are "questioning the sanity of people like myself". Most sexual reassignment centers require two years of counselling before the procedure. Alexis objects to the counselling and seems to propose that physicians ought to treat castration and penile amputations as casually as nose jobs.
A few years ago I attended a program at the American Psychiatric Association’s Annual Conference. An editor of the DSM was under attack for describing gender identity disorder as a mental illness. But in the course of the debate, in a remarkable display of having your cake and eating it too, the transsexual woman who argued against its inclusion was forced to admit that a DSM diagnosis was necessary after all. Why? Because otherwise people suffering from the disorder could not get their health insurance company to cover the cost of the procedures.
Which leads to the $64,000 question. If transsexualism is a disease, then is sexual reassignment the cure?
Let's look more carefully at this notion. Sexual reassignment, with hormone treatment and surgery, is a woolly term which is used far too casually. Take the word "reassignment". What are defenders of transsexualism implying when they use it? In my view, they are relying upon both hoary old Freudian ideas and a silly recent movement called constructivism. The upshot of these two schools of thought is that nature is unimportant compared to nurture. Society and technology always trump biology. So using the word "reassignment" implies that sex is an arbitrary category imposed by the dominant culture through the family. From this perspective, sex is merely a societal convention. In the same way that we expect men to be soldiers and women to be nurses, we expect boys to be boys and girls to be girls. But things can change: women can become soldiers and men can become nurses. So, hey, why can't boys become girls and girls become boys?
Our unquestioning acceptance of the phrase reflects the modern separation between sex and reproduction. Sex has lost its primary meaning as a relationship of two beings vis-à-vis the procreation of life. At conception, men and women are bestowed an unchanging role in the procreation of offspring. As male and female, we can either participate or not participate in that relationship; but we can’t switch roles. We can't be reassigned.
What happens in sexual reassignment? Doctors employ a range of pharmaceutical, surgical and cosmetic procedures to produce either more feminine or more masculine features. Some trans-women may only take up electrolysis and breast augmentation. Others spend tens of thousands for amputation, castration and vaginal construction. Obviously, these procedures destroy the procreative relationship.
The most famous transsexual, Renee Richards, has publicly expressed regret about her decision. Born as Richard Raskind in 1934, she went to Yale and became an eye surgeon and an international tennis star. She even married and fathered a child. But in 1977 she had sex reassignment surgery. She even competed in the US Open in various women's and mixed doubles. But in February 2007, she told the New York Times, "Better to be an intact man functioning with 100 per cent capacity for everything than to be a transsexual woman who is an imperfect woman."
Newsweek presents transsexuals’ pursuit of sex change as inevitable. However, sex researcher J. Michael Bailey in his book, The Man Who Would Be Queen, notes the decision for sex reassignment has a "rational component" and that the "large majority of boys who start out looking transsexual ultimately do not pursue sex reassignment."
The most outspoken critic of sexual reassignment has been Paul McHugh, MD, a member of the President's Council on Bioethics. After becoming chairman of the Department of Psychiatry at the elite Johns Hopkins University in Baltimore, McHugh began studying gender disorders and the sexual reassignment program at his university. After discovering that many transsexuals had strongly masculine interests, McHugh became sceptical of the standard story about "women trapped in men’s bodies." He became convinced that reassignment should be discouraged. Eventually Johns Hopkins stopped doing the procedures.
McHugh’s scepticism was eventually supported by research indicating that bisexual and heterosexual transvestites and transsexuals are sexually aroused by the idea of being a woman. They fantasise about being the female during sex. A sexologist from the Canadian Clarke Institute, Ray Blanchard named this desire autogynephilia. Transsexual physician Anne Lawrence has described autogynephiles as "men trapped in men’s bodies."
In a 2004 article in the journal First Things, McHugh pulls no punches. In a long account of how he managed to persuade his colleagues that sex reassignment was bunk, he asserts that: "We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia."
I have witnessed a great deal of damage from sex-reassignment. The children transformed from their male constitution into female roles suffered prolonged distress and misery as they sensed their natural attitudes. Their parents usually lived with guilt over their decisions — second-guessing themselves and somewhat ashamed of the fabrication, both surgical and social, they had imposed on their sons. As for the adults who came to us claiming to have discovered their "true" sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it.
Many cities have had much less qualms about cooperating with this madness. Last November, New York City’s Public Health Board recommended that people be allowed to change the sex on birth certificates if they provided evidence from a physician that the change would be permanent. Transgender advocates praise the health board for eliminating anatomy -- and any other physiological, genetic or medical requirements -- as proof of sex. A spokesman for the New York Transgender Rights Coalition, offering some armchair Freudian insights, praised the change as "a move away from American culture’s misguided fixation on genitals as the basis for one’s gender identity".
In moving away from anatomical considerations, health commissioner Dr Frieden announced a new standard for redefining one's own sex. Frieden emphasized that it’s the "permanence that matters". Permanence? For Frieden this meant two years of living as the opposite sex. But how would a doctor prove that this two-year requirement? With hidden cameras? A physician would become merely a rubber stamp for anyone who appears in his office and claims to have lived as a woman for two years. Still, transgender advocates pushed for the elimination of any medical requirements.
The swift public response surprised the health board. Hospitals complained that women would be forced to share rooms with men. Prison officials complained that they would be forced to transfer men to female facilities. Dr McHugh warned the board that such changes would make sexual identification impossible. "I’ve already heard of a ‘transgendered’ man who claimed at work to be ‘a woman in a man’s body but a lesbian’ and who had to be expelled from the ladies’ restroom because he was propositioning women there," he said. "He saw this as a great injustice in that his behavior was justified in his mind by the idea that the categories he claimed for himself were all ‘official’ and had legal rights attached to them."
The Board of Health withdrew the proposal. "This is something we hadn’t fully thought through, frankly." Health Commissioner Friedan admitted. "What a birth certificate shows does have implications beyond just what a birth certificate shows."
The madness is beyond transsexualism.
Theron Bowers MD is a Texas psychiatrist.
Silvername wrote, “Such freedom is not absolute and only remains freedom as long as it does not violate God’s Word”
And who are you to say what “God’s Word” is? The bible is a human creation. Those who equate it with God’s mind are, sadly, engaging in idol worship.
Dr. Bowers, the one positive thing I have to say about your essay is that you’ve added something to the issue of language, it’s use in transsexual discourse, and some of the problems inherent in it. Terms like “sex,” “gender,” “gender identity,” “sex reassignment,” “transgender,” and yes, even “transsexual,” (which I will continue to use here for lack of a better term), all contain liguistic flaws. The fact is that we yet haven’t come up with truly effective terminology for discussing the transsexual experience.
You wrote, “So using the word “reassignment” implies that sex is an arbitrary category imposed by the dominant culture through the family. From this perspective, sex is merely a societal convention.”
Most of us trans activists frame our aguments in a physical/biological context. Our sense of gender is inscribed in the hardware before birth. The Transsexual experience isn’t merely about gender roles or the relationship between sex/gender and society. It also, includes our relationship to our own bodies and body chemstry.
Your argument conveniently omits any mention of the effects of sex hormones on the brain. As a transsexual man (female to male transsexual), eight months into transition, I’ve found the mental effects of HRT to be highly significant, and extremely positive. At a loss for how to describe it to someone who has never exprienced “cross-sex” HRT, I have to resort to metaphors like, say, a diesel engine running on unleaded fuel, then finally recieving the proper fuel. The improvements I’ve noted in my memory and concentration are remarkable, and it has nothing to do with any change in social interaction, because the external changes haven’t progressed far enough for other people to read me as male.
Hence, I must agree, in part, with McHugh’s statement, if only in its spirit rather than its letter: “We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.”
But I must ask: Why do you psychiatrists think that the physical aspects of sex reassignment are all about genitalia? What about the rest of the body? Personally, I’m thrilled with the hair and muscle growth, among the myriad other changes occuring, and the testosterone has corrected a mild anemia.
That should tell you something about our motives for surgery, and the underlying element of addressing the problems of sex-specific bulges that appear beneath our clothing. It’s cosmetic, but cosmetic issues do effect a person’s quality of life, sometimes profoundly.
You wrote, “Sex has lost its primary meaning as a relationship of two beings vis-à-vis the procreation of life.”
Very well. If that is true, then the word “sex” needs to be eliminated from the discourse on mind-body incongruity. What do you propose we replace it with? Yes, “sex change,” female to male or male to female--All of us transsexuals, (I hope), acknowledge the biological fact that at the end of transition, (if there can be said to be an end), we’re physically intersexed. But isn’t that where we started out, just differently intersexed?
The goal of transition is to become more comfortable in our own flesh. The choices we make regarding the available medical procedures are nothing more or less than an attempt to achieve that goal. Some of us (most os us, it seems to me) are happy with the results of our decisions. Some will have regrets, but still be better off than before transition. Some will wish they hadn’t transitioned in the first place. That’s life. People make bad decisions every day. Actually, we all make bad decisions at some points in our lives. It’s how we deal with them, and learn from them, that ultimately matters most.
You wrote, “Hospitals complained that women would be forced to share rooms with men. Prison officials complained that they would be forced to transfer men to female facilities.”
Yes, these are problems. I think the only real solution is to reorganize the gender-based structure our society’s institutions are founded on. We need to acknowledge the reality that “M” and “F” do not encompass the whole of humanity, that there is a third sex,“I,” that includes people with chromosomal variations, ambiguous genitalia, and congenital, (possibly genetic, as new research suggests), abnormalities like transsexualism. This certainly presents difficulties, but if we are to progress as a society, we can’t ignore the inconvenient reality of human variation any longer.
Wolfgang Eli Beilschmidt
Thank-you for your mostly kind responses. For now, I want to briefly address a few themes among the respondents.
A few have tried to frame this as a religious debate. I have not appealed to any religious authorities and I think that any discussion of religion is a non sequitur for this article.
Some seem to criticize the article for not being a thorough scientific review. I did not intend to write a scientific review. The article is a reflection upon the intersection between science culture and politics. But I will address a couple of the scientific issues in a future post.
I do apologize to Dr. Bailey and Blanchard if any inferred from my citations that Drs. Bailey and Blanchard do not support sexual reassignment surgery. Both do.
I have more but I have to go.
TB
I would like to respond to Lish.
I find it Ironic that you talk of how much of a success story treating transsexuality with hormones and surgery is while deriding psychologist and MD’s. The track record of satisfaction is probably due to gatekeepers gate keeping. Consider the case of Russel Reid. a British psychologist who was disciplined due to the complaints of patients who say he “rushed” them through treatment. All he did was give them exactly what they asked for. http://www.guardian.co.uk/gender/story/0,,2085903,00.html Perhaps he should have been stricter then as far as we know they would have complained if he did not give in to their demands.
How can the psychologist win? How can the satisfy their patients? I guess some people just cannot be happy. I am glad I stuck with physics.
I think that the comments of Figaro and Pinky, need to be adjusted. While it is true, that fertility in opposition to one’s gonadal sex has not been achieved, neither has alteration of certain limbic nuclei in the brain either. Thus the comment of ‘barriers that are not ‘jumpable’”, needs to also take into consideration that changing the basal brain, is a “barrier” which is “not ‘jumpable’”. But, we can to a great degree change the genitals. To a great degree it is very jumpable. Thus, it is often appropriate to jump the genital barrier, if the basal brain is likely to be in discordance with the current genital status. Fertility will be lost, but persons born who have chromosomes of one sex and anatomy of the other sex, are infertile as well. We certainly don’t need to hear comments from Dr. Bowers, that at conception, men and women are bestowed an unchanging role in the reproduction of offspring. Because, that is simply not true. (In fact, a normal XY male zygote, can change into a fertile XX female embryo!). We also don’t need to hear about McHugh, Meyer and Blanchard, as if they have described something new. Self psychologists, ego psychologists, and object relations analysts have been describing for many years what is now RE-labelled autogynephilia. Even the popular use of “paraphilia” was a very big change in terminology, from that which for many years, was described under “perversion”, by theorists in these three analytic schools. But, I doubt these non-transsexual (though “sexual dysphoric") types, represent the hypogonadism found in around 40% of Benjamin’s transsexual patients. Of course, psychiatrists, psychoanalysts, and clinical psychologists, are going to “psychopathologize”. They will invoke “perversion”,
“paraphilia”, “pathological narcissism”, “resistance”,
“acting out”, “libidinal castration anxiety”....One of the best things Benjamin may have said in his 1966 book, is that “Freud was no Freudian in the sense of some of today’s practitioners.” and that the “disharmony” of our emotions may well come from the “dishormony” of our endocrine glands. Have you noted that those criticizing the treatment of transsexuals, don’t usually offer substantiated alternatives to the treatments which they criticize?
Psychiatrists and MD’s like Bowers, Blanchard, and Bailey have colonized MTF transsexuals for decades, exploiting and stigmatizing us as metally disordered in the course of promoting their own professional careers. Gays and lesbians were pathologized in much the same way, up until homosexuality was removed from the DSM in the 70’s.
The psychopathological mythologies these MD’s weave about transsexuals have never been based on anything more than anecdotal accounts of unscientifically selected patients. After a century of pontification, they can offer no tangible proof to support their claims that transsexualism is a psychatric disorder, and their success rate in treating transsexuals with psychiatry is near zero.
By contrast, the effectiveness of hormonal and surgical treatment of transsexuals is a long-term undisputed success story, with a remarkably low rate of patient dissatisfaction. As medical techniques have progressed, the range and subtlety of available treatments has expanded beyond genital surgery into a detailed exploration of the complexities of human sexuality. Humane treatment of transsexuals is only a fraction of the potential benefits of freeing the practice of medicine from the shackles of superstition and religious taboo.
I won’t refer to the article itself but instead to the comments made about it. I just want to throw a couple points that I consider worht thinking about:
- “I think we have the freedom to decide how we want to live our lives; not by decisions swayed by religious inclinations of a doctor at Johns Hopkins.”
Freedom is not and end in itself despite the desperate claim of people nowdays. Just because I decide that I want to fly, am I going to change my body in order to make my desire a reality? It seems a silly example, however that is what some people pretend when they want to jump the barriers of nature, which, I’m afraid to say are not ‘jumpable’.
-Freedom is a means to achieve happiness. Is happiness about sex? Man is an animal, yes; but it is a ratioanl animal who is therefore capable of higher goals than this of self-satisfaction or ‘self-realisation’. If one thinks of the true meaning of happiness, he/she will find that the matter of sex is not by far the first meaning of it.
Just a remainder which is always very useful: the exemption confirms the rule.
It is amazing, that claimed psychiatric professionals peep their heads out of the wood work when there is a positive surge on social and medical response, to improve the lives
Of men women, children and families who suffer do too social and psychiatric ignorance
too propagate their own agendas.
Not one person referenced in this article reported by Theron Bowers is no longer credible
within their “professional” community.
It saddens me greatly to see at the cost of the most vulnerable, these psychiatric “assumed” professionals goals is research money and their personal careers and institutions are falling to pieces, because the medical community has become
educated of the abuse on human life over decades – That gender variance is not
just isolated to gender variant/inter-sexed individuals, but everyone who walks
the earth.
This is a social sickness, not a mental illness…. And where the mental health community
has abused this position of “mental illness” and words such as disorder to hold onto their
dwindling stake of a practice at best is questionable as a therapeutic form of healthcare.
Gone are the days, where psychiatric professionals is given an opportunity through perpetuated ignorance, and given to them by social law. Using religion as a basis
To substantiate and abuse to gain public support for “birth normal’s” that happen in 1 :500
people born in global society -
The world is changing, and people will no longer stand for psychiatric bully’s as it seems too, they seem to follow each other in a pack, as it seems to be the same individuals for many decades causing such havoc, and in any other form of healthcare, these individuals would lose their licenses and be thrown out of practice –
The APA is very aware of the conflict amongst it members, and what is on the line regarding the future and position of the APA as an adequate form of healthcare. The greatest problem of the APA as many professionals would suggest, that there is no method of governance, public safety of psychology professionals as there is medicine.
Most of the general public is unaware of this – and is sits squarely on the shoulders of the APA for public accountability of member’s practices and academic publishing. This problem stems to the very highest level of the APA and is the “old boys school” attitude.
This is where the focus should be placed – Not on the victims of their practice.
There are a lot of incorrect assumptions in this article. The sex of the brain, much like the sex of the genitals, is affected by pre-natal hormones at a particular stage of pregnancy. A surge of the wrong hormones while the genitals are forming will result in genital intersex conditions (formally called hermaphrodites).
A surge of the wrong hormones while the brain is forming it’s gender will result in transsexualism. Given that we can’t re-gender the brain yet, is it any wonder transsexuals seek to re-gender the rest of their bodies?
This is an example of what Blanchards theory does in the hands of a psychologist of some authority who does not fully understand it. In paragraphs 13-15 Dr Bowers seems to conflate two different ideas.
The rational choice that some transsexuals make does not imply that the need for transition or at least a alternative lifestyle is not innate. For example a transsexual who likes men would not transition if it would make them so unattractive that they would have significant trouble attracting a mate. Such a transsexual may also post pone surgery because they cannot afford the doctor they want. Or for any number of reasons.
Furthermore interwoven into her work is a problematic, old fashioned assumption that it is more natural for a transsexual to have been homosexual as a male. :tsk: :tsk:
Dr Bowers if you are going to write about these issues you better be allot more careful.
Life is sacred. Marriage has begetting of a child makes them ‘procreators’ of God. Sexuality is more than the genitals, it involves the totality of a person.
This is really not well-researched. You clearly haven’t talked to many younger transsexuals, *or* their parents, and yet you feel confident to disseminate your views in the face of this vacuum. Of course, had you done so, you might have felt less able to write an article with such purity of purpose.
I have friends who’ve suffered greatly to be where they are. They are frequently people of extraordinary intelligence and a level of courage that would put the average human to shame. Many achieve real happiness, in the face of people such as yourself, who have the overweening arrogance and stupidity to make categorical and forceful statements about the state of mind of another, different, human being, and to attempt to force a frankly wrong agenda on the psychological and psychiatric arenas.
June 9th, 2007
The fatal flaw in the theological view taken on this article is that guess what, many people from different walks of life wholly reject organized religion’s view of the world.
Anthropologists have documented the large majority of Native Americans accepted and elevated what they called two-spirit individuals i.e transsexuals to positions of prestige and many were shaman or the doctors for their tribes. Throughout history outside of the narrow brush painted by Christianity, transsexuals can be found throughout history in every culture, in varying degrees of societal stature, not always negative.
of course we know how Catholics loathe the transsexual, seeing how during the Spanish Inquisition they ended up murdering Joan of Arc for her refusal to quit wearing male clothes. So egregious was her offense in the eye of the holy church that after she had died, but before the body was destroyed, the fire was extinguished so the executioner could show the onlookers that Joan of Arc was indeed biologically sexed female. But to show what good sports the church is they did finally canonize her, better late than never.
If anyone needs a reason why transsexuality should be removed from the DSM and un-categorized as a mental illness, this article - written by an MD psychiatrist - should do it. Theron Bowers’ pseudoscience is even too much, even for J. Michael Bailey. That says it all.
Dr. Bowers is wrong on many counts in this article. At conception, men and women are NOT bestowed with an unchanging role in the procreation of offspring. An XY zygote at fertilization may undergo one or more mitotic non-disjunction events, which can result in a mosaic chromosome pattern which is compatible with female fertility. There are many other conditions which may have comparable results. Also, fertility is clearly not synonymous with one’s sex. There are XY and XX persons with the sex reversal syndrome, who have only anatomy which is opposite to that expected by their sex chromosomes. It not surprising, that in regards to Renee Richards case, Judge Ascione after reviewing expert medical testimony, ruled that according to “overwhelming medical evidence, this person is now female”. Clearly the mental state needs to match the morphological changes. Bowers can clearly learn alot by re-studying the Olympic decisions.
In regards to Johns Hopkins University and Dr. McHugh, Bowers omits that others at JHU, stated that the decision to halt SRS was “political”, and that the Meyer study, which McHugh speaks of, has been found to be severely flawed in methodology. Indeed most subsequent findings have not reached the conclusions of McHugh and Meyer. Transsexuals do not simply request a cosmetic change, but also a functional one as well. Furthermore, McHugh and Blanchard have described and re-labelled phenomena which are well over 100 years old, and which has been previously described by those in the ego psychology and object relations schools in the 1940’s through the works of Gertrude and Ruben Blancke of the 1970’s. Much of what Bowers speaks of, is not even related to transsexualism, but instead non-transsexual types. Yes, Bowers and McHugh are clearly the ones stuck in the old Freudian schools.
Dr. Bowers,
You, of all people, should know what constitutes a cogent and properly researched argument. This article contains neither.
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