Posting here because I value politics posters insight, and this is undeniably an ongoing political issue, mostly due to public facilities.

http://cnsnews.com/news/article/mich...der-sex-change

(Linking to "CNSNEWS" because I believe WSJ requires a subscription

Cliffs:

Former Chief of Psychaitric Medicine at John Hopkins Hospital and Chair of Psychiatry at the University likens Transgender patients to those suffering with anorexia - in other words, they believe they are fat, but are not (they believe they are the opposite gender, but are not). Calls it a mental disorder that should be treated, rather than indulged.

Thoughts? With a common sense approach, I find it hard to disagree with him, but find myself conflicted as I've always felt supportive of transgender rights.

I think the first part here is incorrect. It's not that they believe they are the opposite gender, but that they don't feel like they were born the correct gender, or say a male who doesn't feel like a male.

iana trans-expert though, so grain of salt

I find it to be an interesting topic, but that doesn't mean I know a whole lot being neither trans nor trained in psychology. What I do know is that this doctor is at odds with the current consensus.

My understanding is that transgender people aren't considered delusional. That is, they don't look in the mirror and see something different to reality. They're fully aware of what sex they have. The question is whether sex and gender are the same or two what degree they are linked.

When someone is dangerously thin but believes they're overweight, their belief is at odds with reality. When someone believes they like eating, they like eating in reality. Again, my admittedly amateur understanding is that being transgender is far more like the latter than the former. When you believe you're a certain gender, you really are that gender. Whether your body conforms to that is a separate issue.

If Dr McHugh has a point, it falls short in that the current best evidence based treatment is what we have now: in depth therapy followed by some level of reassignment, from lifestyle changes to hormones to surgery. Everything I've come across seems to indicate that this dramatically improves the lives of people. Many of the problems of the transgender community then manifest in the way society treats them.

What solution is McHugh proposing? Where's his evidence that it actually works? He may be worth listening to in that running away with a current treatment and never considering alternatives could do long term damage. But then what are we to do with all the people whose suffering is being eased by the current treatment? It doesn't sound right to experiment with alternatives on them rather than give them something shown to work.

Meh, people used to say the same thing about homosexuality. Comparing gender dysmorphia to something self-destructive like anorexia seems like a real stretch.

Exactly. It seems obvious that "indulging" anorexia is objectively unhealthy while "indulging" gender dysphoria seems to be working out ok so far.

One part that stood out to me was this:

This seems to support exactly what the transgender community is saying: transition makes their lives better, the problem is with how they relate to society. And that's a problem of how they're treated and not internal to themselves.

LOL at anyone who thinks that psychiatrists know as much about mental disorders as clinical psychologists or even clinical social workers. (not a snipe at the OP)

The fact that this psychiatrist arrives at his "gotcha" by comparing suicide rates between post-op transgenders and the non-transgendered (when the former should be compared to the non-op transgendered) suggests that either he has an agenda against the icky trans and/or he never took any classes in experimental design.

Gay people still get beat up for being gay after legalizing ssm, ergo we should ban ssm

http://www.slate.com/blogs/outward/2...tq_issues.html

There are lots of things that aren't considered mental illness that could be and lots of things that are that don't really have to be. The only thing that matters is finding the best way to bring happiness to people who are in distress. If someone can figure that out in their own via cross dressing or even gender reassignment, that's great, and we should all be happy for them. If they feel like they need to seek out therapy to deal with their unhappiness instead, that's their business. Best of luck to them either way.

I think the issue because much different when you talk about teenagers who haven't fully matured yet.

But if were talking about adults I would be interested in an unbiased study to determine happiness levels before and after. It's very hard to do because the bias is that society treats trans ppl terrible. Still I can't imagine a trans person being much happier looking like an extremely ugly girl which most do.

As a psychiatrist, I can confidently say that we as a group certainly know more about mental disorders than social workers. I'd say it's a tie with clinical psychologists (with psychologists and psychiatrists having a lot of knowledge overlap and then some different areas of expertise).

Anyway, I'll be back to this thread later to comment more on topic in case anyone here loves me as much as I love me.

Pretty sure there's plenty of resources if you hit google to show you that, in spite of the limits of your imagination, transitioning eases distress and makes people happier.

Apart from the gender issue which it's not really possible to be wrong about as it is what you identify with (as opposed to your sex which is a matter of body parts):

We should be very wary of psychiatrists or anyone else deciding what is a mental disorder unless the issue is itself causing the patient a problem or manifests on others in some violent way. Transgender people can suffer badly because of social acceptability but that doesn't make it a disorder as its a problem with society not with them.

Anorexia is different because it itself harms the anorexic - that's a disorder.

Out if date doctor believes out of date doctor stuff. Probably an imbalance of yellow bile imo.

As shown this is reality being forced to conform with his narrow expectations and so studies are being misread. Which is ironic.

Funny last line. I am glad you found this thread and look forward to reading your input.

from a comment on that article:

"As a bisexual that's hated himself most of his life I'm actually offended by the transgendered apologists trying to implant broken logic into the minds of our depressed mentally ill youth. I'm not against sexuality beyond heterosexuality at all. I actually think its natural and healthy. Building a strong relationship with another person is beyond sexuality or gender roles

The concept that you need to completely change your outward appearance to make yourself happy is sick. Its no better than people so obsessed with their appearance that they implant balloons in their breasts or chop their faces up until there is nothing left of their original self. Its one thing if you have an actual deformity and surgery restores your body to natural functionality. Its a whole different argument when you feel its necessary to physically and chemically chop up your perfectly healthy body up to conform to society's stereotypical gender roles.

I feel there would be no transgendered people if we finally grew out of being ******ed neanderthals and learned to love ourselves and each other beyond our outward appearances."

The commenter doesn't understand the difference between sexual attraction and gender identification.

It definitely is a mental illness to some degree, but that shouldn't be taken as negatively as it sounds, as somewhere around 20% of people have some type of mental illness or disorder, in varying degrees of severity. Transgenders should be accepted (rejection is probably the biggest issue they have to deal with) and I'm not sure if there is some type of treatment or counseling that would help as well, or if we know what the best answer is yet, as I don't think enough legitimate studies have been done as it probably was taboo to do so until recently. It could be a combination hormone treatment or sex changes (along with societal acceptance) is the correct answer, it could be something else entirely, I don't know and I don't think anyone else does yet either, and probably won't until it is studied from an early age which most parents probably try to hide/deny until it is too late, although that is starting to change.

I think this really answers the question as best as we can formulate the issue with our current understanding.

There's nothing definite about it. At some point in this discussion, we may have to define mental illness, but that's not easy to do cleanly. Right now, we use a rather functional definition -- abnormal (whatever that means) thoughts, feelings, or behaviors that impair one's ability to function in society (work, play, love) or that are very distressing to the individual. It's not unreasonable to say that feeling the gender opposite your sex is distressing, but I'd say it's having the sex opposite the gender you feel that's distressing. And there's a difference that anorexia helps illuminate. With anorexia, the problem is the feeling, not the body. Losing weight doesn't alleviate the distress felt by an anorexic.

+1

An analogy if you will. You are a Japanese woman who paid to have a relatively common plastic surgery to make your eyes more "Western".

But suppose you are Japanese woman who is convinced you were born in the wrong "race" and feel the eye surgery is the only thing you can do to fix your racial identity issues. You are also a prisoner and convicted murderer. You successfully sue the state to pay for your operation primarily because the gay lobby espoused your cause.

Itt psychiatrists teach us that chromosomal abnormalities are psychological.

Self hate + not thinking clearly = one really really bad comment. I hope you weren't quoting this as an argument of some sort.