More comments on controversial trans-theory

I wanted to revisit the subject of Autogynophelia, because it seems to me that, the way it’s described, it seems to fit me as well as anything else that I’ve read.  I actually went to the link provided in an earlier post and read the information given there, and as I read the article, I started to see a lot of myself in the description.  It was actually quite depressing to realize that I fit the profile pretty well.  It took me several days to come to terms with that realization, but having previously come to terms with the fact that I wanted to be a girl and that it’s not some horrible disease, but rather, a condition shared by a lot of people, made it easier to come to terms with this description.  I must add that I don’t think that it applies to all of us, but I think it applies to some of us.

I don’t think AutoG has anything to do with early onset gender confusion, I think that would be more properly termed ” a prenatal intersex developmental abnormality”.  AutoG just doesn’t fit the conditions, in my opinion.  Neither does “homosexual transsexual”, because many early onset gender variant people are attracted to people of the opposite physical sex.

I’m still trying to figure this thing out myself, but some things I know about myself are:  I don’t remember any gender confusion as a young child, I was a sensitive little boy, but I don’t remember any confusion about my gender before the onset of puberty.  If my memory is somewhere near correct, my gender confusion started with puberty, but it took me a while to even realize what was going on in my head, probably several years.  By the time I was 15 or 16, I knew what it was, I just didn’t know what to do about it.

There’s always been a sexual connection to my cross-dressing, it did seem to get less over the years, but that may have been because I was trying to supress that part of it, I really didn’t want it to be about sex.  I have always felt more comfortable in “girl” mode, I still would rather be a girl than a boy, it makes me happy.

However, what got me to thinking about this whole AutoG thing is that I still get an “arousal charge” when I first change from the “old me” to the “new me”, especially if I’m excited about how I’m going to look when I’m done transforming into Amber.   It’s interesting that I made 2 discoveries at about the same time.  My body is no longer devoid of basic sex drive due to HRT, it seems to have adjusted somewhat to the current balance of hormones and and I now have a slight bit of sex drive.  That “thing” between my legs is still mostly dead, but not entirely now.  Of course, that’s what led to the discovery that I’m still capable of being turned on by getting dressed.  It doesn’t react very much, it’s just the nerve twinge, but that’s enough to know what’s going on.  I’d like to think that it’s just a residual artifact, but, at this point in my life, I need to be honest with myself.

So, I come to the 20 dollar question, does this mean that I shouldn’t transition?  I’m not really sure about that one yet.  I’m continuing to stay on course while I think about all this heavy stuff, in fact, I was just prescribed Provera by my Endocronologist yesterday, which made me a happy camper all day.  It’s interesting that this point, I haven’t found any reason to stop transition other then this latest injection of illogical doubt.  I realize, logically, that this latest “label” doesn’t really mean much, I still want to be a woman, I still feel like I should be a woman, and I suspect that I already think like a woman.  I’m not a mind reader so I’ll never know for sure, however, I relate more easily to women then men.

I’d be happy to read any thoughts or comments that the rest of you might have on this, some input on this might be helpful to me.

Mercedes Allen responds to accusations of scaremongering

On a post to her personal blog, and cross-posted to Bilerico and Transadvocate, Mercedes Allen reflects on the responses to her original Uh-oh post, including several that have been reported here and elsewhere.

I and others have been accused of scaremongering in the ongoing debate(s) surrounding this issue. Dr. Forstein has some excellent points for us to examine. Some of the other aspects and debates, though, I still stand behind.

Mercedes goes on to respond directly to Henry Hall’s comments:

Henry Hall accuses me of scaremongering with regard to my concerns about removing any diagnosis of GID from the DSM, without some better model to replace it…
…I am not fearmongering: I am saying, don’t cut the trapeze rope until we know that the next bar is within reach.

She also acknowledges the importance of Dr. Marshall Forstein’s statement by saying:

I can admit that my own personal panic led me to overlook the fact that the DSM itself does not recommend treatment. I was wrong and my inexperience got the better of me. This is not a small point, and we need to take some comfort in that. Scaremongering? Perhaps, though not intentionally.

Read Mercedes’ thoughtful and comprehensive response here.

Are We Maladaptive?

Okay, so I got myself into a bit of a tiff with Abby down below. Here’s the link.

In general, the conversation is about how GID should be classified in the DSM. The tendency, obviously, is for us to want a kinder, gentler revision…one sensitive to our feelings, and easier to schlep to the public than something like “autogynephilia”. Ideally, we’d get it removed entirely.

That doesn’t seem likely to me, of course. Unlike homosexuality, transsexuality requires treatment (currently that treatment involves hormones and surgeries…hopefully that will always be the case). And as long as treatment is necessary, the doctors will need a set of diagnostic criteria…hence the DSM.

But maybe I’m wrong.

Maybe gender dysphoria is a physical ailment, as I’ve so often heard said, rather than a mental one. Maybe it’s like having kidney stones. Kidney stones often require surgery, but I’m pretty sure they’re not listed in the DSM.

Maybe we can prove that gender dysphoria is like kidney stones.

Harkening back to my undergrad days and my Abnormal Psychology class (thank you Ms. H.!), along with the help of Google, I was able to dredge up the criteria for mental disorders.

For a given behavior to qualify as a mental disorder, it must meet these four points:

  • Statistical Infrequency
  • Deviation from Social Norms
  • Personal Distress
  • Maladaptiveness

The first two are obvious…we meet those. No argument here.

Personal Distress seems obvious. Yes, the dysphoria we suffer causes us distress. The same was (and still is, occasionally) said of homosexuality. Is it the dysphoria itself that causes the distress, or the way the rest of the world treats us? I suppose that question can only be answered by the individual.

The one that really gets my goat, though, is the maladaptive piece. According to one website I looked at:

A behavior pattern or characteristic is “adaptive” when it is constructive, helpful, healthy and contributes to the person moving in a valued direction.

A maladaptive behavior is the opposite then…a behavior that is destructive, unhelpful, unhealthy, and contributes to a person moving in a non-valued direction. The site gives the example of heroin use as being maladaptive (duh).

So what behavior are we talking about here? If we’re talking about having gender dysphoric feelings and not acting upon them, then yes, I’d say that’s a maladaptive behavior. But shouldn’t we be looking at it the other way? Shouldn’t we wait until a person does act upon a feeling, then judge whether it’s adaptive or maladaptive? To use the example above, the urge to use heroin is only maladaptive when acted upon; to not act upon it is responsible, and therefore adaptive. I’m going to go out on a limb here and say that the same standard should be applied to all such observable behaviors. And most times that I’m aware of, acting upon gender dysphoric feelings results in a person “moving in a valued direction” (except, of course, where Personal Distress rears its head).

Is this going to be the case for everyone? Probably not. There may be people out there who meet all four of these criteria. And there’s no reason the DSM can’t include an article that addresses the needs of these individuals…they did it for homosexuality. But for the rest of us – and every successful transition is another case study the DSM crew should look at – is there a way we can be excluded from the onus of GID and still receive the treatment we need?

To be perfectly honest, even I’m not convinced by my argument. Obviously, being transsexual is not like having kidney stones. And while I think the whole adaptive/maladaptive thing is interesting, I’m sure I’m not the first person to think of it. Sadly, it’ll take more than an hour’s worth of Google research before I’ll be able to completely repudiate decades worth of mental health research, but in the meantime, there are a few people out there who can make those kind of claims.

Some thoughts on controversial Transgender theories

With all the talk lately about the people selected to revise the TG section of the DSM-4, I thought I throw my thoughts into the mix also.

Part of the controversial theory proposed by Dr. Ray Blanchard is dividing the trans community by sexual orientation (“homosexual transsexuals” vs. “autogynephilic”). Just the basic concept of dividing the the trans community by sexual orientation seems to be missing the entire point of the trans experience, it’s not about sex, it’s about gender. Gender identity and sexual orientation are two different things entirely.

I believe that there are trans people who could fit into the catagory of “homosexual transsexual”, but that’s only one part of the trans experience and certainly is not an inclusive description of a large part of the community. I also believe that there’s people who fit into the “autogynephilic” catagory, but I don’t think this description fits people who choose to fully transition, or even those who are forced to be, or choose to be “non-op” due to various circumstances. I think autogynephilia would be more appropriate to describe fetish cross-dressers, this is, after all, a sexual description, and not a gender identity model.

It’s my belief that, much like Freud, these “Doctors” can’t seem to separate sex drive from non sexual issues. Being sexually driven males of the species makes it difficult for them to remove sexual background from non sexual logic.

I’ve often wondered if “autogynephilia” is a description that applies to my experience – my gender issues have, in the past, had a strong sexual component to them. My question concerning this is, if my desire to transition is sexually motivated by autogynephilia, then why do I still have so much conviction about continuing my transition when the spiro has removed my sex drive and my ability to get and keep a strong erection. I’m impotent and totally uninterested in sex and sexual relations, and yet, I’m more convinced than ever that I’m doing the right thing for myself. The doubts and fears that I have about transition are about my ability to successfully blend into the general female population. “Passing” is important to me, but not for the purpose of a relationship, I just want to be accepted as a female person. (There’s an entire blog that could be written about the desire to be accepted.)

There’s so much more about being cross-gendered than any sexual issues, but some people, even health professionals, just can’t see past their own sexual biases. There are way too many successful transitions for this to be about sex. However, I have to ask the question, if transition was sexually motivated, is that a problem? If it results in a healthy, happy person who can live a fulfilling life for themself, does it matter what the motivation is? The desired result of any psychological therapy is a well adjusted person who can live a satisfying and fulfilling life, and transition is the only thing that has been proven to solve the issues faced by strongly transgendered people. No other therapy has been shown to be effective.

Personally, for me, no matter what else happens in my life, I don’t intend to ever go back to the testosterone driven life that I suffered with in the past. I’m hoping to make that permanent in the not too distant future, hopefully sometime this year, with a medical procedure known as orchiectomy. Another large stepping stone on the journey.

News concerning the DSM – V. (a.k.a. “uh-oh.”)

The following was posted on Transadvocate.com website. I’m reposting it because like Mercedes, I see this as a very consequential and momentous event in the psychological and medical treatment of transgendered people. — Lori Davis
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

(crossposted in several places, and people are welcome to forward this on freely to others in the transgender and GLBT communities, as I see this as being very serious — Mercedes)

A short time ago, I’d discussed the movement to have “Gender Identity Disorder” (GID, a.k.a. “Gender Dysphoria”) removed from the DSM-IV or reclassified, and how we needed to work to ensure that any such change was an improvement on the existing model, rather than a scrapping or savaging of it.

Lynn Conway reports that on May 1st, 2008, the American Psychiatric Association named its work group members appointed to revise the Manual for Diagnosis of Mental Disorders in preparation for the DSM-V. Such a revision would include the entry for GID.

On the Task Force, named as Sexual and Gender Identity Disorders Chair, we find Dr. Kenneth Zucker, from Toronto’s infamous Centre for Addictions and Mental Health (CAMH, formerly the Clarke Institute). Dr. Zucker is infamous for utilizing reparative (i.e. “ex-gay”) therapy to “cure” gender-variant children. Named to his work group, we find Zucker’s mentor, Dr. Ray Blanchard, Head of Clinical Sexology Services at CAMH and creator of the theory of autogynephilia, categorized as a paraphilia and defined as “a man’s paraphilic tendency to be sexually aroused by the thought or image of himself as a woman.”

Drs. Blanchard, Zucker, J. Michael Bailey (whose work has even gone so far as to touch on eugenics) and a small cadre of others are proponents of dividing the transsexual population by sexual orientation (”homosexual transsexuals” vs. ”autogynephilic”) and have repeatedly run afoul of the World Professional Association for Transgender Health (WPATH, formerly HBIGDA), and openly defied the Standards of Care that WPATH maintains (modeled after the original SoC developed by Dr. Harry Benjamin) in favor of conversion techniques. Blanchard and Bailey supporters also include Dr. Alice Dreger, who re-stigmatized treatment of intersex, controversial sexologist Dr. Anne Lawrence, and Dr. Paul McHugh, who had set out in the begining of his career to close the Gender Clinic at Johns Hopkins University and has been one of our most vocal detractors.

An additional danger that gay and lesbian communities need to be cognizant of is that if Zucker and company entrench conversion therapy in the DSM-V, then it is a clear, dangerous step toward also legitimizing ex-gay therapy and re-stigmatizing homosexuality.

I am not familiar with others named to the Work Group. It would be worthwhile looking into any history with WPATH that they might have, to know if we have any positive advocates on board, or just more stigmatizing adversarial clinicians. They may be appointed primarily to address other listings categorized as ”Sexual and Gender Identity Disorders,” I don’t know. They are:

* Dr. Irving M. Binik, McGill University, Montreal, Canada
* Dr. Peggy T. Cohen-Kettenis, VU University Medical Center, Amsterdam
* Dr. Jack Drescher, New York Medical College, St. Luke’s-Roosevelt Hospital Center, NY
* Dr. Cynthia Graham, Isis Education Centre, Warneford Hospital, Oxfordshire, UK
* Dr. Richard B. Krueger, NY State Psyciatric Institute and Columbia University, NY
* Dr. Niklas Langstrom, Karolinka Institutet, Stockholm, Sweden
* Dr. Heino F.L. Meyer-Bahlburg, Columbia University, NY
* Dr. Robert Taylor Segraves, MetroHealth Medical Center, Cleveland

The APA press release states that for further information regarding this, to contact Rhondalee Dean-Royce (rroyce@psych.org) and Sharon Reis (sreis@gymr.com), though it’s possible that they may govern the press release only, rather than have any involvement in the decision to appoint Zucker. The APA itself is headquartered at 1000 Wilson Boulevard, Suite 1825, Arlington VA, 22209. Their Annual General Meeting is currently being held (May 3-8, 2008) in Washington, DC.

I’m poorly situated (Western Canada, with no travel budget) to lead the drive for this, which I see as a very serious danger to the transgender community. So I am calling on the various Transgender and GLBT organizations to band together to take action on this, and will assist in whatever way that I and AlbertaTrans.org can.

I am also calling upon our allies and advocates in the medical community and affiliated with WPATH to band together with us and combat this move which could potentially see WPATH stripped of its authority on matters regarding treatment of transsexuals.

– Mercedes Allen, May 5, 2008