Tuesday, 22 July 2008

A Nose By Any Other Name Would Smell

There has been a lot of discussion about terminology, and words like "intersex", "transsexual", and phrases like "disorders of sexual development". Whether transsexuality is rightly classified as a mental illness or not.

Some of my thoughts, trying to regularise the matter, and fit in with the currently understood definition of "mental illness".

Intersex conditions can reasonably be called disorders, at least, inasmuch as they affect fertility, sexual function, continence etc. They are disorders the way albinism is a disorder. Some might call it a "natural variation", though.

The typically Celtic red hair/fair skin combination, universally recognised as a "Natural variation" could also be called a disorder, as it has real effects on health under some circumstances. It has significant health risks in high-sunshine climates, sort of Albinism-light.

Many Intersexed people who don't see themselves as "disordered" in any way, just a bit unusual, like people with blue eyes, object to the phrase "Disorders of Sexual Development", but they don't have a say in it. The Authorities Have Spoken. As usual.

As above, so below. I've been involved a little on a CAH (Congenital Adrenal Hyperplasia) support forum - CAH is an Intersex condition that masculinises females. And the majority of women that have it insist that their somatic anomaly is no worse than can be gotten from PCOS (Polycystic Ovarian Syndrome), which is not an Intersex condition, and so CAH shouldn't be either. They're not "Intersexed", they have no connection with those "weirdoes and freaks" who have "gender issues". *SIGH*

And some who have other Intersex conditions want nothing to do with those weirdoes and freaks", the Transsexuals, who have "gender issues". *SIGH* again.

My view is that Transsexuality per se is caused by cross-gendered neurology. And I classify it as one of many different Intersex conditions because of that. So it shouldn't be classed as a "mental illness".

On the other hand... the distress caused by severe transsexuality should be so classified, the same way that distress caused by other purely physiological conditions, some congenital, some not, should be. The distress over having the wrong-shaped body for the brain and mind is similar to the distress caused by removal of breasts due to mastectomy, or penectomy due to cancer or accident. And to the extent that that distress can be alleviated, and functionality restored, by surgery and/or hormonal treatment, then it should be. To the extent that it cannot, psycho-therapy may be useful in some cases to help the sufferer (and I choose that word advisedly), cope as best they can with it.

I find it monstrous that children who are arbitrarily surgically modified to have an appearance that conforms to genital norms, whether intersexed or not (and in the past, there have been some dark hints by surgeons that some normal boys were castrated purely because the parents wanted a girl child), and whose mind is not bigendered enough to be content in the new role, are labelled as "mentally ill". It seems the height of inhumanity that they be told late in life that psychotherapy to help them accept what others have tried to force them to be is their only option, that corrective surgery is unavailable to them because.... well, just because.

It is only slightly less monstrous that transsexuals should be treated the same way, especially since their discomfort is so intense that so many have "co-morbidities", ranging from chronic depression, through substance-abuse and other self-destructive behaviour, all the way to suicide.

It is inhuman that various religious groups have either done their best, but been ill-advised by superstitious psychiatrists (as in the Catholic church), or have adopted an anti-Science mentality and so are deaf to medical evidence. They see a physiological problem as a moral one, just as those born with harelip were once thought to be the Spawn of Satan.

22 comments:

SnoopyTheGoon said...

I would laugh at these incessant terminology wars if I wasn't aware of the power that terms wield in our politically correct world.

And it's tragic how much power all religious sects still have over public discourse. In this century. Grr...

Bad hair days said...

A intersexual friend of mine has been told be her doctor, that a harelip is often corelated to intersexuality (she had one, when she was born)

RadarGrrl said...

It seems to me that the distress caused by GID is a separate issue from GID itself. GID is the cause, the distress is a symptom of that cause. I view GID as a physiological problem, i.e. the body not fitting the mind, than a neurological one, i.e. the mind not fitting the body. You canot fix the mind without doing something invasive or nasty, and this would probably change the person. If changing the person is the goal here, then we, as a community, are in a world of hurt.

Nick K.D Chaleunphone said...

My View is this, Transsexuals are still considered a mental illness because they still have that DSM VI label attached to them.

It's true, most intersex including myself, do not want anything to do with the weirdos, freaks namely the transgender.

Laserlight said...

Snoopy, are you saying you want our public discourse all to be pragmatic and self-interested and whatever I can get away with to benefit myself? Because if you'd prefer ethics and morals, you can't really separate out religion, which is generally a source of those ethics and morals.

Of course, no religion is without flaky, biased, ignorant adherents. But that also applies to pro sports teams and large businesses and hobbies and political parties and so forth. Blaming all religions per se sounds rather sophomoric.

Laserlight said...

Zoe, for those of us who are not ourselves trans/intersex, maybe you could do a chart to show which terms cover what and to what extent they overlap? I concur with Snoopy about terminology wars and their political effects. I'm continually disgusted by the US political use of "progressive", "liberal" and "conservative", when none of those are accurate.

RadarGrrl said...

To Nick:

I'm not mentally ill. TS should be removed from the DSM, especially with asshats like Blanchard, Zucker and Lawrence possibly being on the committee, the absolutely worst choices possible for it. IMHO the birth defect model is far more accurate.

Nick K.D Chaleunphone said...

radargrrl,
At the moment, TS still sits in the DSM VI manual and I don't see that changing for the foreseeable future. Their's no scientific proof to warrant removing TS from DSM VI at the moment. That's why TS will never be in the same category with intersex because TS has that DSM VI label attached to them and having TS is not considered having a genetic condition.

Battybattybats said...

Nick,
I put it to you that every one of the points argued to remove homosexuality from the DSM in the past can also be applied equally well to transexuals and transgender.

I suggest to you that there is no scientific proof to warrent it being or remaining IN the DSM.

And if so therefore it should be removed and only unjustified bias causes it to currently remain there.

Regardless of catagory or causation unless you have proof that it should be in the DSM in such a way that homosexuality shouldn't then the inclusion of one in the DSM long after the removal of another just prooves that the DSM is useless to your argument as it is inconsistent.

stephen david said...

My View is this, Transsexuals are still considered a mental illness because they still have that DSM VI label attached to them.

Someone wrongly jailed isn't guilty.

Placing candy in the fruit bowl doesn't turn it into fruit.

Nick: Are you prepared to give your word that if TS was removed from the DSM, that you would no longer consider people that suffer this to be "freaks with a mental illness"?

Nick K.D Chaleunphone said...

I doubt that the APA will ever take GID/TS/TG out of DSM VI or V. Their's no scientific proof or reason to warrant taking GID/TS/TG out of DSM. Since they have no genetic basis or genetic proof, they still occupy and have the DSM VI and V attached to them. Their's no way the APA will ever let them off.

One of the biggest reasons why, The TS/TG community dose not have the clout, numbers and political will that the LGB community has in getting themselves off the APA's DSM manual

They basically will still be attached to the DSM V for the foreseeable future in some shape or form.

Nick K.D Chaleunphone said...

No, because regardless what the APA says, Society will always still consider TS/TG as freaks, weirdos with mental illness.

stephen david said...

One of the biggest reasons why, The TS/TG community dose not have the clout, numbers and political will that the LGB community has in getting themselves off the APA's DSM manual

So hang on, are you saying that gays/bis/lesbians are still metally ill sick freaks, they just had / have the political clout to get it taken out of the DSM?

What you've just asserted is that the DSM has no absolute bearing on whether something is a mental illness or not, just what Society thinks we can legitimately persecute.

I ask my question again: If a biological basis for GID/TS is shown, will you accept this or will you insist that GID/TS is a mental illness despite evidence to the contrary?

Society is comprised of individuals...

Battybattybats said...

"No, because regardless what the APA says, Society will always still consider TS/TG as freaks, weirdos with mental illness."

But Nick, that's clearly a statement made in error.

1. your not omniscient so you cnnot predict future social changes with enough accuracy to support your use of the word 'always'.

2. many cultures throughout human history have not just failed to consider TS/TG as freaks, weirdos with mental illness etc but have in fact accepted TS/TG people. some cultures have in fact elevated TS/TG people as sacred!

As society has in the past held TS/TG people as acceptable and even sacred then to assume this will never occur again is irrational and illogical.

One might assume for example that the human species might go extinct sometime awefully soon and prevent that from occuring but this is still speculation at best and leaves the use of the word 'always' as unsupportable

Logic, sense, history, anthropology all say that your statement is clearly in error.

I'm yet to hear of scientific proof that TS/TG is a mental illness and the only operative differenece with the removal of homosexuality from the DSM you've come up with is political power rendering your comment about it remaining in the DSM absolutely pointless.

"My View is this, Transsexuals are still considered a mental illness because they still have that DSM VI label attached to them.

It's true, most intersex including myself, do not want anything to do with the weirdos, freaks namely the transgender."

Also might i point out that referring to people with mental illneses as freaks and weirdos even if you are right about TS/TG being a mental illness is no better than calling people with physical illnesses or developmental differences freaks and weirdos.

So if you dissaprove of people calling intersex people freaks and weirdos (and I'd agree with you if you did) then it's absolutely inexcusably wrong of you to call mentally ill people freaks and weirdos!

You should be ashamed of yourself for such shameful and warrentless disrespecting of the mentally ill!

They are people too! Mental illness is not a moral failing but an illness. It's sufferers deserve not one iota less sympathy and compassion than sufferers of birth defects or viruses or bacterial infections or cancers.

Nick, irrational bias such as your disrespect and discrimination towards the mentally ill is frequntly a sign of mental illness, such as Borderline Personality Disorder. You might suffer a mental illness yourself without even knowing it! Shouldn't we still show you the same respect either way?

I reccomend you get an appointment with a clinical psychologist and get yourself checked out in case you yourself are mentally ill. Even if not a short amount of cognitive behavioural therapy should help you deal with your bigotry towards the mentally ill so you wont disgrace yourself again in public by looking like some sort of horrible person by calling the mentally ill freaks and weridos.

If TG/TS is a physical condition don't you owe them all an apology? If it is a mentsl illness WON'T YOU STILL OWE THEM ALL AN APOLOGY? (and not just TS/TG but all mentally ill too)

To avoid oweing anyone an apology and won't you need to show that it is neither a physical condition nor a psychological one but a deliberately unethical act? No chance there.

Come on Nick. We all have failings, we all pick up biases through our lives but you've been given a clear opprtunity to face yours down with calm logic and fairness. Your trapped in a logic trap of your own making as you can't call TG/TS people weirdos or freaks whether they exist through physical or psychological causation without justifying others calling intersex people freaks and weirdos and in effect hurting yourself! That statement is shooting yourself in your own foot!

But I'm sure we can be a forgiving bunch of people.

Don't let your desire not to be associated with TG/TS lead you to compounding your mistake and hurting yourself more. There is no need to insult people by calling them weirdos and freaks. Not the mentally ill, the physically ill, the disabled or those with developmental anatomical differences. I'm sure you don't like the intersexed being called freaks, I'm sure we both can agree that is wrong, so therefore you logicly should apologise for calling TG/TS people freaks, mentally ill or not.

Nick K.D Chaleunphone said...

Stephen,
What I said and u didn't understand it that the Gay, lesbian and bisexual community had the clout, political will and the numbers were and are their to force the APA to get them off the DSM books.

Where as the TS/TG community their is no clout, political will or the numbers are not their in the TS/TG community to get themselves off the DSM books.

That's why you don't see being gay, lesbian or bisexual is in the DSM VI or V books whereas you still see TS/TG/GID in the DSM VI and V books.

I would not accept the idea that GID/TS/TG has a biological origin because their is no concrete proof and all their is just theory's that has never been tested under scientific control and validated by duplicating the research.

All the TS/TG/GID people live by is theory's that are not proven facts.

Nick K.D Chaleunphone said...

Battybattybats,
Last I checked bigotry isn't a mental illness in the current DSM-TR VI Manual. The last I checked in the DSM-TR VI, TS/TG/GID and CD is still in the DSM-TR VI. So you better read up on the current DSM-TR VI manual before you come here and say stuff.

Yet because TS/TG has no biological origin, they are still classified as a psychiatric disorder and still placed in the DSM-TR VI. Their is no psychiatrist or psychologist or the APA in the world willing enough to drop the TS/TG in DSM-TR VI manual. It simply won't happen because their is not scientific proof to warrant it.

The reason why intersex is given a pass in society and ts/tg isn't. Is because society understands that intersex people didn't have a choice when they crawled out the womb. Intersex fetus didn't have control over their genetic blueprint or the DNA code to say what they wanted.

Whereas the transgender they have a choice and the choice they make, they get ostracized from society and called freaks and weirdos.

That's why society will give a pass to intersex because it's not their fault for being born different and it was out of their control. Whereas society won't give a pass to the TS/TG community because what they choose to do, is not what society wants.

If someone called an intersex a freak or weirdo, I would fight like a dog, even if I don't know that intersex person, but because he's my genetic kind, I have to jump in and fight for my genetic kind.

That's why their are intersex people like myself who don't want to deal with the TS/TG community. We don't want any part of their freakish or weirdo lifestyle

Battybattybats, I suggest you check yourself with a psychiatrist or psychologist because you need to get your meds checked and you need some serious counseling and maybe some religious help too. That way they can help you sort out your psychological and social issues and maybe even give you meds to control your behavior.

I don't owe anyone an apology. I have my views and if you don't like it, you can leave the planet anytime you want and the door is available for you.

Their are people with mental illness, but they don't act like freaks and weirdos. They don't ask the the APA to remove them from the books and force themselves in front of the public.

Battybattybats, You suffer from deep seated personality and social issues and is frequntly a sign of mental illness, such as Borderline Personality Disorder. You might suffer a mental illness yourself without even knowing it!. You might even be a danger to yourself and society as well.

So for the sake of yourself, don't butt into intersex affairs unless your one of them or you are intersex born intersex.

Bad hair days said...

> Where as the TS/TG community their is no clout, political will or the numbers are not their in the TS/TG community to get themselves off the DSM books.

I think Nick has a point here, while the rest of his text is just ridicules ignorant.

Nick K.D Chaleunphone said...

That's why compared to the LGB community, they have the clout,they have the numbers to back them and they have the political will and backing.

Whereas the TS/TG community, their is no clout, no numbers to back them and they don't have any political will or political backing at all.

So who has the the backing, political will and clout and who dosen't

That's why you see gays, lesbians and bisexuals who are no longer on the DSM VI manual. Whereas you still see the TS/TG/CD/GID in the DSM VI manual. Mainly because they have no clout, political will or the numbers to force APA to consider taking them off the DSM VI books.

Bad hair days said...

Thank you Nick.

I have a created a blog similar to the one Zoë has. But I put no name behind it. I can't pretend that I can live stealth cause my community effort is not forgotten (professionwise) and some long term fellows followed me to my new profiles even without me inviting them. So I think you taught me to put a name behind it. To start to build a bigger block of people against false treatment. As, by the way is yours ;-)

Sarah Roth
PS: btw. Its still a sad thought never beeing able to be steath. Espacially since I'm hetero, often confronted with closed minds who still can google.

Battybattybats said...

"Battybattybats, I suggest you check yourself with a psychiatrist or psychologist because you need to get your meds checked and you need some serious counseling and maybe some religious help too. That way they can help you sort out your psychological and social issues and maybe even give you meds to control your behavior."

Nick, I've been to several psychs (CBT for improved coping strategies for chronic pain and other CFS symptoms as well as to be checked for disability pension eligability with check-ups to be certain of continued eligability for my CFS)

And I got the total all clear. I'm not on any meds at all and have both 6 Drs and 4 Psychs checked me out and determined thats appropriate.

As for religion. Another FAIL Nick. I've STUDIED comparative religion. I have friends who are experts in the field. Whether christianity, judaism, islam, gnosticism, animism and a whole lot more I know plenty and have access to even more knowledge.

Bigotry isn't in the DSM sure...

But I guess you don't realise the paradigm shift in the psychological field being caused by the rapid take up of cognitive behaviour therapy (because of it's much higher measurable success rate) that means more and more psychs are totally disregarding the DSM in favour of different models of mental illness entirely.

In CBT one of the main causes of mental illness is THE ACCEPTANCE OF EXTREME IRRATIONAL BELIEFS.

Bigotry IS one of those extreme irrational beliefs. (and no, transgender isn't. I did ask but nope. Not according to the most respected psych in my region. It's about experience, not belief. The science isn't finished on causation of the experience yet but when the fact is that attempting to 'treaat' or 'cure' TG/TS the same way as genuine mental illnesses actually causes genuine mental illness and helping people accept being TG/TS cures genuine mental illness it's a safe bet that you've got it utterly wrong Nick!)

Therefore by holding to an irrational belief (bigotry) you cling to the causative element of many mentsl illnesses. That actually raises your risk of developing a mental illness the longer you hold to it if you haven't got one already. As opposed to TG/TS where accepting it lowers the chance of mental illness while denying it increases it.

And in case you didn't notice, changes of and unusual behaviour is actually common amongst the mentally ill. Clinical depression, manic depression, dysphoric depression, chronic anxiety, schizophrenia.. which of these COMMON mental illnesses doesn't cause dramatic changes in behaviour?

None.

So again, even if TG/TS were a mental illness you would still be guilty of crass and shamefull discrimination and villification by calling the mentally ill (or those you believe to be mentally ill) freaks and weirdos.

Which is especially disgraceful coming from an intersexed person considering the repugnant term 'freaks of nature' is often still disgracefully used when discussing intersex in society.

I guess you don't know much about mental illness at all. Nor science, logic, nor ethics too.

You've all but stated that the DSM is just a catch-all for an unexplained phenomenon cause you have no proof that its a genuinely mental illness other than a circular argument about it being in the DSM while admitting that the absence of the comparable homosexuality in the DSM renders the DSM biased, useless and disregardable. Remember the song 'There's a hole in the bucket'? That's your argumnet right there.

Unless you have as much proof of it being a mental illness as that proof you would require to accept it being a born condition then it is scientifically invalid to claim that it is certainly a mental illness DSM or no DSM.

"That's why society will give a pass to intersex because it's not their fault for being born different and it was out of their control. Whereas society won't give a pass to the TS/TG community because what they choose to do, is not what society wants"

See once again you show your lack of knowledge and understanding of history and anthropology. And a total unwillingness to pay attention to valid points i've already raised.

Society has accepted both TG/TS and IS in the past, it has also not accepted all of them in the past punishing all of them with death. Therefore you cannot validate your assumptions that the current status quo will continue indefinately.

Besides, your also ignoring that a LOT of people still agree with imediate surgical intervention of IS children.

Society is in a constant state of flux.

Isn't it time you reassessed your conclusions, especially there assumed precepts? End the hypocracy of caling people freaks and weirdos when you don't like being called that either.

Your view, that TS/TG is different from IS does not require you to be insulting towards TS/TG people, towards mentally ill people or to hold to embarassingly circular arguments and irrational views.

The basic trouble is you want there to be an answer now with absolute certainty of the causation of TS/TG that is unlike intersex but Science has a lot more to explore before you can have that.

You'll have to put up with the same fact all of us do. Untill certainty is reached we will all live in uncertainty.

Untill enough tests are done on epigenetic switches during brain development as well as throughout life (didn't think of that one now did you! What if an epigenetic switch activates TG/TS post birth but still genetically! Causing hormonal and behavioural changes!) and until large enough studies are done and repeated in the fields of psychology, neurology etc etc then the only FACT will be:

We don't know for sure yet!

So while I know you won't like it we can't scientificly RULE IN OR RULE OUT the phenomenon of TG/TS as being related to the phenomenon of IS.

Any other statement contrary with the above must be recognised as reasonable conjecture or if stated as certainty it becomes clearly an outright lie!

The absolute facts are as yet uncertain either way Nick.

Deal with it!

Anonymous said...

Zoë,

I have to disagree about intersex people being "disordered". The term DSD, just like GID, is pathologizing what is a normal biological variant.

Also may I ask why you tolerate that guy Nick Chaleunphone? He's a transphobe that is just spamming this blog with his bigotry.

Leah

stephen david said...

Hi Leah,

I personally hold out some hope for Nick. On his blog, he has admitted that male and female brains are different, that everything starts off as female and some funky complicated hormone kind of stuff happens to the fetus to cause the brain to develop. The only thing he's struggling with is the conclusion that if the *biological* differentiation process goes wrong somehow you could end up with a masculined brain in an XX fetus or the converse.

Nick's also got enough reason to be transphobic in some ways - he has Kallmann's syndrome (which is caused by a dud gene on the X chromosome) - he seems to get it mixed up with Kleinfelter (he keeps saying he has an extra chromosome which would be Kleinfelter XXY, but Kallmann's syndrome males are XY - it is possible to have both syndromes though AFAIK). Anyway they thought about reassigning him to female when he was a child and decided not to.

From his blog:
http://kallmanns-syndrome.blogspot.com/2006/03/what-would-life-be-like-if-i-had.html
What i've been thinking is, what would be like if they did go through the surgery. I would think that life as a female would proubly be better than as a male. Though i kinda think of myself as a female with a male body with Female DNA and female thinking.

He doesn't have "gender issues by the way"...

Eventually he'll twig that while each individual study is small and only indicates rather than proves that TS people are biologically different from non-TS people, together all these studies are making an increasingly convincing case that TS is a biological issue at it's root.

Take Care,
SD