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Jul 1

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An example of Trans-Phobia in Society

I’d written previously about internalized-trans-phobia and noted that one reason why this happens is that “trans-folk have been … misunderstood and the object of derision”.  The following is unfortunately a good example of this.

(This was taken at a June 27, 2011 press conference with Presidential candidate and former Pennsylvania Senator Rick Santorum)

…I was with a couple this weekend who live in Vermont, and they have a similar situation up in Vermont… and their second grader has to come home and deal with Transgender Children, who are talking about Transgender Issues in second grade.  These are things that are going to have a profound impact on children… when children are going to be forced to be taught about all of these issues that come with the implementation of gay marriage…it’s going to have a devastating impact on our children.  It’s going to have a devastating impact on families and it’s going to have a profound impact on religious liberties….

That’s one powerful little second-grader… destabilizing religion in America. (does this mean she doesn’t have to do her homework?)

Putting aside for a moment Senator Santorum’s obfuscation of the issues of Gay Marriage and Transgender Children, the Senator as a respected member of society, is transmitting with his words and even more with his tone, the idea that transgender children are ‘less than’, ‘other’ and objects worthy of derision and ridicule.  He is incredulous that a “normal” second-grader would have to associate and learn about his or her gender variant class-mate.

I would say that the Senator gets to be the poster-child for hate this week and can now consider himself to be a contributor to trans-phobia.

Jun 18

transgender regret
15 Comments

On Regret of Gender Transition

There are some people who undergo a gender transition (either fully or to some extent) and then regret having done so and “de-transition”.  This post attempts to explore this phenomenon.

Some reasons why this might occur include:

  •  The person is not transsexual.  The person may have found by going through their transition that they are not in fact comfortable living in the other gender and that they feel either gender queer or more closely aligned with the natal gender.  Certainly instances of transitions involving surgery might have been prevented if there were a greater attempt to determine this beforehand; however, just like with non-trans issues, we often go ahead with things we think are right for us only to discover that they aren’t.  Sometimes the discovery just isn’t possible without trying it out.  The ‘real life experience’ (see WPATH’s standards of care) is an attempt to systematize this discovery process before any major surgeries.
  • Regardless of whether the person is truly transsexual or not, it’s possible that because of having lived so long with gender dysphoria and accompanying social and physical dissatisfaction, one may think of a full gender transition as a magical ticket to happiness.  I have seen this (sometimes unconscious) wish accompanied by other unrealistic expectations such as:  the idea that one will have a social community, better social skills, be more popular, etc.  When this turns out not to be true, there can be confusion and uncertainty that tends to focus on one’s gender transition.  It may be that the gender transition was in the person’s best interest, yet other causes of unhappiness and personal problems had not been sufficiently explored and worked through.  Sometimes with gender variant people, work on other problems are delayed because the gender issues tend to take precedence.
  • The person encountered too many problems with transition (i.e. dissatisfaction with their post-transition life).  These problems could include lack of family support, loss of partner, problems with transition in the workplace, disappointment with the outcome of surgery and problems “passing” as the new gender.  Additionally, transitioning is hard.  There are many hoops to jump through and one enters into a group of discriminated against people.  This can be exceedingly disconcerting for some.

Levels of regret

Certainly a person who has made a gender transition can have certain regrets that are not extreme enough to cause them to wish to de-transition.  The WPATH Standards of Care notes that “cases are known of persons who have received hormone therapy and sex reassignment surgery who later regretted their inability to parent genetically related children”.  Other less extreme regrets can involve loss of certain benefits of privileges commonly associated with one gender or another.

Some research on regret:

Pfafflin F., Junge A. (1992) Sex Reassignment: 30 Years of International Follow-up Studies after SRS: A Comprehensive Review, 1961-1991 [publication online]. Translated from German  into American English by Roberta B. Jacobson and Alf B. Meier. IJT Electronic Books.

This study looked at 70 previous studies and reviews on outcomes following sex reassignment surgery.  These included 2000 individuals from 1961 to 1991.  This doesn’t take into account individuals who transition without surgery.  About 70% of MTF individuals were satisfied and 90% of FTM individuals.

Krege S., Bex A., Lummen G., et al. (2001). Male-to-female transsexualism: a technique, results and long-term follow-up in 66 patients. BJU International. 88:396-402.

 This study shows little or no regrets possibly due to surgical advances.

Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you. email: info@amikaplan.net

May 5

Sexual and Gender Identity Disorders | APA’s proposed changes (part 2) – DSM-5

The previous post with the first version of the proposed changes can be found here.

A few notes before the quoted text.

  • The big changes from the last revision (not from the last DSM) are that

1. they’ve dropped ‘gender incongruence’ and gone with ‘gender dysphoria’

2. they have added a ‘B’ criteria of distress and

3. they have added a ‘post-transition’ specifier.

  • Version 5 of the book is due out May 2013
  • the current commenting period will end on June 15, 2011.
  • This is the APA DSM 5 (American Psychiatric Association) site.  The APA “writes” the DSM (Diagnostic and Statistical Manual)
  • It’s important because this will be one of the key tools for how mental health professions view and define gender issues for the coming decade.

The following (in blue) is quoted from the APA site:

_________________________________________________________

Updated May 4, 2011

 Gender Dysphoria (in Adolescents or Adults)**

A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators: [2, 3, 4]**

1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics) [13, 16]

2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) [17]

3. a strong desire for the primary and/or secondary sex characteristics of the other gender

4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)

5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)

6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning,  or with a significantly increased risk of suffering, such as distress or disability** 

Subtypes

With a disorder of sex development [14]

Without a disorder of sex development

See also: [15, 16, 19]

Specifier**

Post-transition, i.e., the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is undergoing) at least one cross-sex medical procedure or treatment regimen, namely, regular cross-sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in a natal male, mastectomy, phalloplasty in a natal female).

Note: Three changes have been made since the initial website launch in February 2010: the name of the diagnosis, the addition of the B criterion, and the addition of a specifier. Definitions and criterion under A remain unchanged.

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