Carolyn Moynihan | Saturday, 15 October 2005

Your gender is not an accident

The idea of medical intervention to change one's sex has gained credibility in recent years. Dr Rick Fitzgibbons thinks that it has been a great mistake.

When a man wants to be a woman, or a woman a man, is it because nature gave them the wrong body? Or did something else go wrong?

The idea that a person's sex is a mere biological accident that can be changed to suit one's chosen gender has wide currency today. But, according to psychiatrist Richard Fitzgibbons, this intellectual fad is not at all helpful to people who are genuinely confused about their sexual identity.

Dr Fitzgibbons, who has nearly 30 years' clinical experience behind him, is the director of a private practice outside Philadelphia and leads the team of the Institute for Marital Healing. He has made a specialty of forgiveness therapy in the resolution of excessive anger, and has co-authored a book on the subject with Robert D. Enright, published by the American Psychological Association.

In this interview with MercatorNet he explains why a sex-change operation is not the answer to gender identity problems.

Dr Rick FitzgibbonsMercatorNet: Are there people who are genuinely confused about their sexual identity—whether they are male or female?
Rick Fitzgibbons: Yes, there are people who are confused due to the seriousness of their emotional pain and conflicts which interfere with cognitive functioning. Many of these individuals have failed to embrace the goodness and beauty of their masculinity or femininity in childhood and in adolescence for numerous reasons.

Unless treated properly, they may go on to hate their masculinity and femininity. Their sadness and lack of acceptance by peers or a parent can lead them to believe that they may be able to escape from their emotional pain and find greater happiness, acceptance and confidence being of the opposite sex.

MercatorNet: It is possible to have a female person "inside" a male body, and vice versa?
Fitzgibbons: No, it is not. A person may feel this way because of emotionally painful experiences primarily with those of the same sex. Initially, they fantasise living as someone of the opposite sex in an attempt to escape from their pain. An excessive fantasy life then can lead to cross-dressing, to a greater identification with the opposite sex and even to a delusional belief that one is of the opposite sex.

MercatorNet: Can a person's sex be changed — surgically or in any way?
Fitzgibbons: No, each cell of a person's body contains chromosomes which identify that individual as either male or female. It is not simply a question of different genitals. Before birth prenatal hormones shape the brains of boys to be different from those of girls. Mutilating surgery and hormone treatments can create the appearance of a male or female body, but it cannot change the underlying reality. It is not possible to change a person's sex.

MercatorNet: What do follow-up studies show in regard to sex-change surgery?
Fitzgibbons:
Dr Paul McHugh reported in an article in First Things that when he was the psychiatrist-in-chief at Johns Hopkins, he studied the outcomes of such surgeries. The study found that while most of the clients said they were happy with the outcome, the various psychological problems which accompanied their feeling that they were the other sex remained unchanged. They still had the same difficulties with relationships, work and emotions. Dr McHugh concluded that "to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it."

MercatorNet: What are the reasons why people seek to change their sex?
Fitzgibbons:
The most common causes are a lack of acceptance and rejection in childhood and adolescence by peers and by the parent of the same sex, deep resentment toward these individuals, hatred of their bodies, intense fears of being betrayed and hurt, and a deep desire to be protected in the world. Less common causes are rejection by the parent of the opposite sex and the belief that if they were of the opposite sex they would receive the warmth and love from that parent which they did not receive as children.

A less common conflict is seen in some boys and men who have powerful artistic and creative gifts, which lead them to experience a strong attraction to the beauty in the female world and to an identification with femininity. This artistic response can begin early in childhood and can lead to a desire to be female. In rare cases, a parent wants a child to be of the opposite sex and dresses and treats the child as being of the opposite sex.

Finally, many of those who seek surgical “sex change” suffered from undiagnosed and untreated gender identity disorder (GID) as children.

MercatorNet: Can these emotional conflicts be successfully treated? Does the desire for sex-change surgery change after such treatment?
Fitzgibbons:
Yes, it is important not to take the desire for sex change surgery at face value, but to uncover the emotional conflict which has led people to think they would be happier or safer as the other sex. The recognition of emotional pain with peers or with a parent leads to the awareness of significant anger which can be resolved through a process of forgiveness. At the same time it is necessary to treat poor body image, low self-esteem, sadness and fears.

As with the treatment of substance abuse disorders, spirituality can play an important role in the healing process. We regularly recommend that Catholic patients work with a spiritual director. Also, in those with faith a major goal of treatment is to help individuals to see accept their unique masculinity and femininity as a positive gift from God.

As the emotional conflicts are treated effectively the appreciation for one's unique and special personhood increases. Subsequently, the desire for sex change surgery is resolved.

MercatorNet: How can parents identify gender identity disorder? Can it be successfully treated in childhood?
Fitzgibbons:
Gender identity symptoms include strong cross gender identification, exclusive cross-gender play, a lack of same-sex friends and cross-dressing. Children with these symptoms should be treated as though something may be very wrong (link to my GID article at http://www.narth.com). Parents and paediatricians should not minimize or overlook these serious symptoms.

The psychiatric literature clearly demonstrates that children with GID can be successfully treated if both parents cooperate in the solution, especially fathers. According to Dr Kenneth Zucker and Susan Bradley, experts in the treatment of gender identity problems in children, treatment should begin as soon as possible. I have an article on this subject on the website of the National Association for Research & Therapy of Homosexuality.

MercatorNet: Last year the Guardian newspaper in Britain commissioned a review of more than 100 international studies of post-operative transsexuals, after interviewing people who regretted having such surgery, and this research found no robust evidence that the surgery is clinically effective. Why do some scientists insist, even against the evidence, that sex can be changed? What is the bigger issue at stake here?
Fitzgibbons:
In spite of the scientific research, the support for the idea of "sex change" operations has continued to grow. In fact, there have been several articles discussing whether it is advisable to begin the "sex change" process in adolescence or even before.

I have personally had the clinical experience recently where a troubled mother found support from two child psychiatrists at different major East Coast university medical centres to begin transitioning her nine-year-old son to a female. Fortunately, the judicial system blocked this medical recommendation, warned the mother and gave primary custody of this boy to his father.

Dr Paul McHugh, whom I referred to earlier, has summed up the philosophy behind this mindset well: "One might expect that those who claim that sexual identity has no biological or physical basis would bring forth more evidence to persuade others. But as I've learned, there is a deep prejudice in favor of the idea that nature is totally malleable. Without any fixed position on what is given in human nature, any manipulation of it can be defended as legitimate. A practice that appears to give people what they want — and what some of them are prepared to clamour for — turns out to be difficult to combat with ordinary professional experience and wisdom. Even controlled trials or careful follow-up studies to ensure that the practice itself is not damaging are often resisted and the results rejected."

People are coming to believe that they can create, use, change and destroy life as they so choose.

Carolyn Moynihan is deputy editor of MercatorNet.


Comments (37)

Mike said...

Thank you for this article,the political correct establishment has lied,manipulated and twisted the facts and science to promote this dangerous idea.."the mistaken body argument”.This article only sheds light through all the rhetoric promoted by men and women who should know better. I left transexuality some years ago the process took a huge toll on me. I can only say is thank you for exposing the lies.

http://www.realityresources.com/

http://www.help4families.com/

http://www.raf-t.org/

http://groups.myspace.com/extransexaul

United States | Friday, 3 August 2007 at 3:48 am

Anonymous said...

Your research and assumptions appear biased.

First, I’d like to say: I was born a boy, and later in my life developed the urge to become female. Yes, I had an intense dislike of my body, but I also truly emphasized more with women than any boy I’d ever met or even heard of.

But I’d like to get one thing straight. I am not “confused”, as you repeat over and over. I am SURE that I want to be female. There is no ‘maybe’, or ‘almost’ about my desire to be the opposite sex. It’s there, and it’s total. I don’t have “gender identity problems”, because I KNOW which gender I am supposed to be. There is no problem, and I know my identity: female.

I’ve had no surgery as of yet, or even hormone therapy; I need a psychologist’s recommendation to receive both, and am currently in the process of finding one. But I’d like to shatter most of your preconceived notions by informing you that I am still attracted to females. Though I haven’t heard of others who would willingly become homosexual, I can assure you that that is what I’m aiming for. In that way, the commonly used explanation that I’m only doing this to “fit in” is thrown right out the window: I have no reason to bring adversity and repression against myself except for the belief that my physical appearance must reflect my self-image.

To your credit, you do expose that changing gender is technically impossible; that my Y chromosome will be forever with me, however much I despise it.

But it is unfortunate that you can’t empathize with those who wish to change their gender, even going so far as to suggest modern medicine should abandon the practice entirely.

The matter remains that this desire to change gender hurts nobody, and brings peace of mind and happiness to thousands of people. If you insist on believing that it’s just and correct to abolish a practice that harms no-one and brings happiness to many, please keep you beliefs to yourself. But if you want to help people, try to emphasize.

-- | Tuesday, 7 August 2007 at 9:41 am

abolishsexchangesurgeries said...

Abolishing these abominations is what’s needed to be done.  Hormones incr. risk of cancers, strokes, heart attacks & no Dr. should be allowed to do this. Sex change surgeries are maimings. Dr. Fitzgibbons is right about the harms of sex change maimings. 

Transexuals have higher incidence of depression & suicides.  The problem is in the mind.

United States | Wednesday, 8 August 2007 at 1:49 am

Anonymous said...

Ah, it’s so nice to hear humans calling other humans “abominations”. Well, regardless of your obvious hostility towards transsexuals, I ask you this: is it maiming to make one human being look like another? Should handicapped individuals be denied prosthetic limbs because they were born the way they were, and are therefore supposed to be that way?
Though admittedly, prosthetic limbs don’t toy with hormones, which need to be kept at a delicate balance. It’s just the principle of the idea.

Oh, and on your accusations that hormones cause cancer, strokes, heart attacks etc, and that transsexuals have a higher incidence of depression and suicides… Weird, I don’t see you citing any sources of viable research, so… you have what we call an ‘opinion’. And opinions are no basis to be making decisions upon the lives of others.

United States | Friday, 10 August 2007 at 12:51 am

abolishsexchangesurgeries said...

Anonymous, your comment are predictable rubbish.  Sex change maimings are synonymous to surgeons amputating the healthy limbs of those who have apotemnophilia. There have been cases where surgeons have maimed patients with healthy limbs because the patients believed that they were born with no limbs.

Cure GID, don’t maim the patient.  The harms of hormones are well known.  Inject the body over a lifetime with hormones & you do get heart attacks, strokes & even certain cancers. Sex change maimings are an abomination just as surgeons amputating the healthy limbs of a patient who demands it is an abomination. Cure the mind, do not maim the genitals.

United States | Thursday, 16 August 2007 at 6:42 am

Anonymous said...

“Your comment are predictable rubbish”? Cute. I wonder how many college classes you’ve taken dealing with logic and reasoning in literature? Well, let’s take your argument apart piece by irritating piece…

apotemnophilia. well, I don’t believe I argued for the case of nutjobs who derive sexual pleasure from amputating their limbs, did I?
Why, in fact, the only similarities apotemnophilia shares with sex-change operations is the apparent “maiming”. Well, maybe you missed this:

A sex-change operation is the process to turn one’s sexual organ into something aesthetically resembling the opposite gender’s sexual organ. Combined with hormonal therapy, this allows the individual to become aesthetically similar to the opposite gender, thereby relieving mental anxiety stemming from extreme discomfort in one’s current body.

Amputation turn one limb (arm, leg, finger, etc.) into something not recognizable as any other natural body part; a stump.

And the second half of your argument: “Inject the body with hormones”? It isn’t a shot; there’s complicated dosages and rations and whatnot involved, that I won’t pretend to understand. Your remark is akin to me remarking that inserting metal rods into a human body is bad for it: well, under irresponsible direction, it is, but under the belt of medicine it allows those hurt in accidents to regain control of their lives.

And again with this GID. Gender Identity Disorder. I’ll repeat myself; there is no disorder about my genger identity. I *know* I wan’t to be female; no maybe about it.

In conclusion… I agree with you on the point that doctors disfiguring patients who demand is unethical, and should cease immediately if it isn’t already illegal.
But you are gravely mistaken if you think that sex-change operations fall under that category.

P.S.: Get a thesaurus. I don’t want to count how many times you’ve used the words “maim” and “abomination”.
And your name is a mouthful.

Have a nice day^-^

United States | Monday, 20 August 2007 at 9:11 am

abolishsexchangesurgeries said...

Anonymous:

You haven’t said anything that I haven’t heard before.  I don’t care if a man believes he was born in a woman’s body, just as I don’t care if a Black person believes he or she was born white instead of Black.  I’m against sex change maimings for the same reason that I’m against a Dr. whitening the skin of some1 who suffers from Racial Identity Disorder.  A girl can not become a boy, a boy can not become a girl & a black person can not become white.

Sex change maimings are the same thing as apotemnophilia & Racial Identity Disorder, even if you say otherwise.  Scientists must cure Gender Identity Disorder & Racial Identity Disorder.  They must not offer maimings, even if the patients demand it.

United States | Friday, 28 September 2007 at 2:02 am

Jennifer said...

The article was interesting, but it was clear that the ideas were driven from a preconceived notion of what is “right” versus “wrong,” and there are religious motivations involved.

I find it so interesting that two groups of people can look at the notion that natal brain wiring supports THEIR point of view.

This article claims, “Before birth prenatal hormones shape the brains of boys to be different from those of girls. Mutilating surgery and hormone treatments can create the appearance of a male or female body, but it cannot change the underlying reality. It is not possible to change a person’s sex.”

Meanwhile, those who see GID as viable/real instead believe that the brain has been impacted prenatally so as to be wired more like the opposite physical sex, so biologically the body can be justifiably altered to conform to the unchangeable brain identity.

See? Different assumptions lead to different conclusions. It would be nice to see someone actually discuss both sides, not just focus on the self-justifying ones.

(For myself, I’m preop M2F.)

United States | Friday, 28 September 2007 at 2:10 am

abolishsexchangesurgeries said...

Dr. Joseph Nicolosi in an article raised the topic of Racial Identity Disorder & that just as it’s bad for a Dr. to Whiten a Black man or woman’s skin because they think they were born White, it’s just as bad for a Dr. to make a girl a boy or a boy a girl because they believe they were born the opposite sex. 

It used to be that if some1 suffered from GID, Drs. would spend time trying to cure the person or better treat the GID.  Yet ever since sex change maimings came out, most psychologists are not treating GID.  Rather what they’re doing is 1st diagnosing whether a person suffers from GID & then if that is determined, they surgically maim the patient. Transexuals are even pushing to remove GID from the DSM.  If this happens, then they’ll next demand that reparative therapists who treat GID be banned.  This sad & it’s even sadder that so many in the medical & psychological communities are participating in these maimings.  Make it illegal to perform sex changes.

United States | Saturday, 29 September 2007 at 12:42 am

SRS+ said...

In my analysis of the comments by “abolishsex.....”, I can easily see that his Father has influenced his belief system to damaging proportions. This person has a lower than average IQ as is evident in his repetitions. Anonymous, you did right in meting out each comment, making it at least more possible for Binky to understand.

He believes everything he reads. I would recommend using a Library, not a Porn shop or a grocery store when seeking knowledge. There is a difference between books that offer you information to help you make decisions and loose leaf publications that help you thru the night.... and you can order Xray glasses from them too!

Anonymous, thank you for your willingness to stick to your guns. These wooly mammoths will die off, on their own, as will their archaic beliefs.

Jennifer, I appreciate your point of view as well.You also come from and speak from experience. I find it amazing that a doctor can spend most or all of his / her career and still get it wrong. But it seems that there is an “old boys’ club” with desires to manipulate the lives of children and adolescents, forcing them to live in their birth sex, regardless of the complications.

Most recent theories are that what has been discussed here is merely on the spectrum of sex and sexuality between male and female, ie hermaphroditism. When 1 in 100 infants present at birth, with genital ambiguities, why should it be such a distant consideration that people can try to live in their birth sex for decades, only to seek resolution as an adult?

Dr. Fitz..., you have had it wrong all of your life. Sad, very sad. Your theories would be a lot more plausible if you had kept up with research over the last thirty years, as I have.

Mercatornet, I am further saddened that a publication such as yours would offer an incredibly biased supposed professional any space at all, unless it is in your dark mission to support such dribble.

Michelle Hogan
Torchlight Gender Support

Canada | Sunday, 7 October 2007 at 8:08 am

MVC said...

Though new in ethical debates between transsexuals and the good intentioned i feel that the transsexual side is arguing from subjective experience while the other is arguing from biological determinism. Whats the confusion between sex and gender? Can a man be anything but a man while he desires to be effeminate? Any disorder or natural occurrence can be explained in terms of 1 out of 100 which doesnt justify or dismiss surgery! I would love to see the physical cause and justification for attempts at castration in order to feel better about ones body. Free will is not absolute no matter how much i want to fly it will not happen, but is getting in an airplane the same thing? No One can choose a lifestyle but should science help if further (if wrong) damage can be done? Why not wait until gender is more than argued choice but a provable biological reality to legalize such an irreversible procedure? No one can say Gender identity crisis (ie when you dont want what you got) is normal average of society let alone nature. If there’s a slight possibility that a person is suffering from a psychological illness surgery should be avoided until tests can be developed to determine mentally ill from true gender conflicts. No one denys how hard it might be for people who might legitimately suffer everyday with genitals they want removed, but there is a difference between removing an appendicitis and genitals, it’s called cure. One does not give a narcissist a mirror just so his quality of life improves. I argue that transgender surgery should not attempt to mimic the opposite sex but be developed completely before it becomes a viable and legally sanctioned option. One might say that this will never happen, but...why? maybe it is because science has to develop, maybe because one does not choose identity. Today i rank among the good intentioned. I seek facts and logical arguments not opinions based on interpreted documents.
-Humble

United States | Saturday, 24 November 2007 at 3:13 am

abolishsexchangesurgeries said...

It’s typical for apologists of sex change maimings such as Michelle Hogan to engage in personal attacks, saying that I have a low IQ.  It’s also easy for Michelle to become arrogant & attack Dr. Fitzgibbons who believes that the right approach to Gender Dysphoria is to treat GID & cure the mind, not maim the genitals. 

While I’m not a repair therapist, the truth is that repair therapists are attacked because politics dominates the discussion.  Apologists for sex change maimings don’t want a cure for GID.  They also don’t want a cure for homosexuality.  They’re against repair therapy no matter what the success is & efficacy is a sideissue.

United States | Friday, 30 November 2007 at 3:22 am

C. P. Dixion said...

You always fail to mention those who are not XX, or XY. What about those with AIS who are assigned female at birth, but are XY? Should they have the right to choose to live as men since they are XY, even if they lack male gentiles and have breasts? What about those who are XX males, should they have the right to live as females? Be real, people with intersexed conditions far outnumber transsexuals, yet they are always overlooked. This is because we remind you that not is all simple!

United States | Saturday, 8 December 2007 at 7:45 am

colby said...

I think that you are way out of line and have no knowledge to what you are talking about. Why say that about people you don’t even know.

-- | Tuesday, 8 January 2008 at 4:46 am

MICHELLE HOGAN said...

Colby, I make my comments based on forensic and profiling principles. My comments above are based on textual and grammatical observations.

I stand by my comments and I put my name on them. I do not hide behind pseudonyms and fake names. This is my life and I lead it completely, COMPLETELY, in truth.

Now, you who call yourself abolishblahblahblah....

My comments toward Fitzgibbons are based on current research. His are based on opinion, not fact and not used by any respected authority today.

MVC (Humble) will keep us untreated due to a perception by one person that there is no proper treatment. Standards of Care have been maintained by gender specialists for years. Have you done your research? I do not see it in your comments. The facts are that 98% of surgeries have been successful, over decades. You are concerned that a mistake may be made. You are right, mistakes are made, because doctors are human. Indeed, some also have ulterior motives, to support their political and/or religious beliefs and imposing them on patients.

This issue has been discovered in CAMH in Toronto. Psychologists running the Gender Clinic there have been found to be supporting archaic treatments for adults and children while receiving funding from religious right groups that are not even in this country. This movement has effected many children in this country, isolating them from the true and proper treatment that they deserve. To me, this is criminal. In fact, one person, who calls himself a psychologist, is not recognized as such in our province or our country by any psychology or psychiatric governing body. And he is not alone. How deep does the con go?

All of you who comment, are you gender dysphoric? Does this issue have a direct effect on you? Colour your comments appropriately or let the real professionals handle the issue. I work with them daily.

Michelle Hogan
Torchlight Gender Support

Canada | Tuesday, 8 January 2008 at 3:01 pm

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