Your gender is not an accidentThe 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.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. 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." 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. 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. |
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Comments (37)
Melissa Malena said...Dear MVC, I think you misunderstood my entire point about whole body chimerism. My point is, if we are to decide that the ultimate criteria is, XX= female and XY=male, there is no
healing to one’s original sex as you mentioned, since the person actually started as two sexes. Also, the “developmental processes and all its factors” which you mention in whole body chimerism, may not be “factors which are towards one healthy teleology” as you state, if it is a true hermaphrodite chimera.
Also, sex and reproduction, may of course be seperate 9even cloning of humans would be reproduction, but not sex), and that is not just intellectual. They also may be seperate from their original developmental processes.
Also, you equate “male” and “Female” factors “winning out over each other”, original sex and reproduction. But, this is not necessarily the case, as we see in assisted reproductive technologies, for example.
I am not stating that a fully functioning reproductive male
wearing a dress, make-up, or breast implants is “both” sexes.
But certainly, if such a male then got a sex change operation, she would then be undeniably of female phenotypic sex. Hormones could also make lactation and breastfeeding possible. Some m to f transsexuals have received ovarian transplants. Do they not ovulate? The fact that fertility in the new sex has not yet been achieved doesn’t mean that the end result is not the same as someone who is born with a malformed sex either.
-- | Tuesday, 26 February 2008 at 8:54 am
MVC said...Melissa,
maybe we are missing each others points i beg your patience as i sift through all this knowledge…
The facts are simple: Genes are the readout for the development of the body.
Genes play a part in sexual development such that without them no sexual or bodily development occurs at all.
There are many factors in sexual development but the out come is always male female or mal-sexual development (reproductively)
The many factors act upon or in unison with genetic code as sexual developer.
Wether you want to call that the two sex chromo or all the factors that attribute to the genetic sexual make up the facts do not change...sex is biologically determined by the genetic makeup. Influences upon the genetic makeup may change the path of sex development but that path is either male female or mal developed.
Whole body chimera changes none of these facts in light that a developed male is ALL of his sex traits in one sexually genetic body as a female to hers. A developed body is a sexual body determined by their genetic makeup (influenced positively or negatively as such).
Original sex is not just the XX or XY of the genes but the whole genetic makeups relation to sexual development… it is genetic or the body develops without genes (absurd).
The body is a single united organism that has specified organs for specified ends such as the sex traits point towards reproduction. Original sex is the pre-established genetic influences for development of healthy reproduction.
The body cannot be completely genetically changed without “re-development”.
Now a person born with a mal-developed sex is defective in regard to its natural genetic end. That end is to be determined as what would be the case if healthy sexual development had happened or could happen (research needs to be done). mal developed sex is not the norm or healthy expression and is in need of cure for proper biological function begging for answers to why maldevelopment occurs and how to fix it in process.
-- | Wednesday, 27 February 2008 at 5:50 am
Melissa Malena said...Dear MVC, you make some errors. You state
“original sex is not just the XX or XY...but the whole genetic makeups relation to sexual development.”
“original sex is the pre-established genetic influences for development of healthy reproduction.”
“A developed body is a sexual body determined by their genetic makeup.”
“..the facts do not change sex is biologically determined by genetic makeup (influenced positively or negatively as such).”
Here is your problem. I didn’t claim that genetics are not involved in sex or reproduction. But you are being too reductionistic. Genetics DON’T occur in a vacuum and there is no orginal sex or reproduction without the environment either. Furthermore, hormones or environmental factors can change what would have occured by the genetics and override the genetic influence. Persons who have a female original sex as you say, can turn out to be males if there is a different
environmental occurence (exogenous hormones or chemicals affecting the fetus). This changed does not need to be via an effect on the gene expression itself. It may also be changed during assisted reproductive technologies. It may also be changed after a transplant. After all, a m to f transsexual who has received functional transplanted ovaries, now has in effect become a man made chimera, having 2 cell lines. An XY cell, which you would claim has an original male sex, may
be changed in the lab.
-- | Wednesday, 27 February 2008 at 8:38 am
MVC said...The sexual changes that occur in human development are either effects upon or causes of the genetic make up of individuals. Genes determine sexual development as they are influenced and express. Genes do not always express their composition because they can be turned “on” or “off” based on “environmental” or “Genetic rules” factors that determine development and “maintain” the body (this can be defective). Just because a person can turn “on” or “off” those cells that express sexual development (after it has already occurred and “matured") does not mean the body has not already developed as a male or a female. The original sex of an individual is not the grand total of female versus male influences and expressions of the body, but the genetic established development behind those influences. No matter how many influences there are upon the genes, they are the genes that eventually “choose” the sex development to be maintained despite the environment. Once the environmental factors have played their part sex has been established. It is this established sex that i call the body choice and original sex of an individual and xx and xy has a lot to do with it. A man cannot become a women unless they are “redeveloped” (made fetus again) which is absurd. Any procedure that takes place in a lab to “change sex” is fundamentally against the body’s pre-established developmental decision to maintain in the “on” position any of its proper sexual expressions and “off” any of its improper expressions and development. Only accidental changes occur unless a fundamental genetic change takes place. It is important to realize that there is still much to be learned about this “fundamental genetic sexual establishment” that establishes the person as a continual male or female in their life despite influences upon the body.
I am not speaking in a reductionism because the human body is not its exterior environment though it is heavily influenced by it.
-- | Saturday, 22 March 2008 at 9:46 pm
Alisande said...to everyone (including the doc):
i’m from the point that the sex of a person is determined by the mind, so as diferent studies show the mind can develop in the uterus to the oposit gender of the body do to hormones in the uterus that may or may not be related to mom hormones. But this doenst stay from here a study involving transexuals have show that brain structures that are diferent in males and females in ftm transexual are exactly as male ones and in mft transexual are exactly as female ones, the study reports that that structures are not bind by hormones so it are hard wierd since the child is born.
And another thing i’m a mtf transexual and i dont have any of that problems that the Dr Rick Fitzgibbons reports. My family is healthy i had have a parent and a mother that tried to raise me as a normal boy, i have brothers and no one of them have a GID or are homossexual. I have always felt like a woman and i have never wiched to be one because i’m one, just have a male body; I dont have problems in relations ships, i still a boy, and have had some boy and girlfriends; I never felt alone or have been put away from the games, played by boys or girls; i’m will start soon hormone theraphy and i just want one thing that is the others aceptt me as a woman.
I’m a woman, as ever i had been, just want to have my social life as it’s suposed to.
Portugal | Sunday, 23 March 2008 at 2:22 am
Melissa Malena said...MVC you are incorrect again. The original sex is indeed a result of a grand total of m vs. f influences and expressions on the body. Also, I think you need to look up DE-differentiation and RE-differentiation. Also, an XY cell can indeed be sex changed in the lab (no quotes needed) to a fertile XX cell. Morphology redevelops in response to a sex change operation. Morphology refers to the shape and overall form of the anatomy. Also, when the transsexual recieves ovarian transplants, the (so called, as you would state, original) sex of transplanted ovaries into a transsexual was female. Thus, the transsexual now has 2 distinct genetic lines. It doesn’t matter that skin cells for instance may still be XY, because she now has ovaries from the donor which have XX cells. It is really not unlike a chimera state, where some persons have all XY cells, except in their ovaries, which would have been their girl but fused into one chimeric person. In fact, it is INDUCED chimerism, producing a gonadally female who has XX chromosomes in her ovaries now.
-- | Sunday, 23 March 2008 at 10:02 am
Administrator said...Thanks to everyone who contributed to this debate.
This article is now closed to comments.
Australia | Monday, 24 March 2008 at 8:20 am
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