Questioning transsexuality

In Bradley Manning Is Not a Woman, Kevin Willamson makes a case that feeling like a transsexual – that is, that one is either a man in the body of a woman or vice-versa – should be regarded as a mental illness to be treated by therapy rather than with sex-reassignment surgery.

The article surprised me by presenting a coherent case for this position that I cannot dismiss as garden-variety social-conservative chuntering. I found the parallel with what Willamson calls BIID particularly troubling. If we treat people who desire to electively amputate their own arms and legs as mentally ill, why do we judge people who want to amputate the genitals they were born with any differently? What makes one an illness and the other a lifestyle choice?

As a libertarian I’m inclined to think that people have a right to mutilate their own bodies any way they like, provided that the surgical and after-care costs aren’t forcibly extracted from anybody else. But libertarian respect for autonomy cannot entirely banish the concept of mental illness either. Some people have minds that are broken and need treatment; respecting their autonomy too much to deliver treatment condemns them to lives full of needless and avoidable pain.

In the rest of this essay I’m therefore going to ignore, on purpose, the question of how to reconcile libertarian values with a theory of mental illness. I feel justified in this by a particularly interesting feature of Willamson’s argument.

Williamson’s contribution is to show that it’s quite difficult to construct a theory of “mental illness” that includes BIID but excludes transsexuality. Given the high frequency with which post-op transsexuals commit suicide, Willamson even could have argued that people with BIID are less ill than transsexuals, evidenced by the fact that they’re less self-destructive. Tellingly, suicide rates are not significantly lower among transsexuals who cannot get reassignment surgery.

Thus: if libertarians are going to have a theory of mental illness at all, we will be required to grapple with the philosophical issues raised by transsexuality in the same way as non-libertarians for whom “mental illness” is a much less fraught and suspicious concept. And that is he last thing I will have to say about libertarianism here.

I’ve known two transsexuals well enough to believe I have some idea of what their inner life is like; I’ve met, I think, four others. I’ve felt sympathy for all of them – but Willamson reminds me that sympathy may be as easy but serious a mistake here as it would be with respect to a paranoid schizophrenic. (This is my thinking, not his; Williamson never discusses paranoid schizophrenics or whatever the DSM is calling them this week.)

How is Bradley Manning’s expressed belief that he is a woman trapped in a man’s body epistemically distinguishable from a paranoid schizophrenic’s belief that (say) he is pursued by invisible demons who compel him to burn his own flesh? I’m a predictivist and judge truth claims by how they cash out as observations of future events; what Williamson forces me to recognize is that I can’t really formulate a consequential test for either claim.

Furthermore, I can’t trust what the “transsexual” Bradley Manning tells me about his situation any more than I can trust what the demon-haunted paranoid tells me about his. In neither case are the referents of their claims located anywhere but inaccessibly within their own skulls.

Accordingly, I can’t find principled grounds to classify one as a delusional system and the other as not. Now, one might say: there are no such things as invisible demons! But: where is the evidence that there is any such thing as “women trapped inside mens’ bodies” or vice-versa?

Willamson reminds us that the concept of a psychological gender identity separate from one’s physical one actually has about the same confirmation status as invisible demons. The only warrant for it is a gallimaufry of speculation based on reports from a population that by objective measures seems to be highly disturbed and dysfunctional (and the 18-20% suicide rate is only the the most obvious indicator).

So, why do we not treat self-reported transsexuals as insane and in need of treatment for a delusional disorder? I can anticipate a lot of possible replies; the trouble is that all of them apply just as well (or just as poorly) to the case of BIID or delusional paranoia.

One of the stupidest possible counters is also probably the most common one: if you don’t accept transsexuals’ reports of their own condition, you’re being nasty and unfeeling to them. Um, OK, how does this apply to paranoids? Am I required to believe in invisible tormenting demons on pain of being considered cruel to those people?

Another, possibly even stupider argument is that if I don’t believe that physiological and physical gender identities can be opposed I am taking the side of Bad People – conservatives, phallocrats, whatever. I don’t really see this as being any different than the religious argument my ancestors might have been given for the existence of invisible demons. It’s just as obviously fallacious.

Back in more religious times, belief in invisible demons was not helpful to people we would now categorize as delusional paranoids; a hefty dose of Thorazine, while not a cure, at least manages their condition, bringing down the incidence of suicides and self-mutilation and other violence.

I don’t actually see, now that Williamson has slapped me upside the head enough so I notice the issue, that a belief in separated psychological and physiological sexual identities is any more helpful to transsexuals. The objective check is that acting on this belief doesn’t seem to reduce their suicide rates significantly.

First, do no harm. We’ll know we have a rationally and ethically sound way of handling “transsexuality” when we find one with sequelae significantly less grim than doing nothing. Right now, gender reassignment surgery doesn’t qualify – Williamson quotes a British research group affiliated with NHS reporting “no robust scientific evidence that gender reassignment surgery is clinically effective.”

I think Williamson is right that it’s time to be much more critical about the theory and ideological fashions that led us to where we are now. A good place to start would be to ask how we might establish that “transsexuality” exists and what it means, after applying the same skepticism that we do to self-reports by other people who report an urge to lop off their body parts.

147 thoughts on “Questioning transsexuality

  1. 1st Post! :\:D/ …Now that we’ve got that over with, I’d just like to add that even the DSM-V is still being debated by the mental healthcare professional community worldwide right now as we speak….

  2. Unlike with homosexuality, it is “politically correct” to say that transsexuals have a disorder. Surgery is one way to (attempt to) ameliorate the effects of this disorder.

    If we accept the premise that your brain could be a separate gender* to the rest of your body, there would be two ways of rectifying this: change the gender of the brain, or change the gender of the body as far as is possible. It is plausible that the former is not yet possible, in the same way that there hasn’t been a cure for homosexuality. While the thought of sex-reassignment surgery is disgusting to most normal people, I could accept that it might be the best option for some people, if that’s what the evidence showed: if people who had undergone it were happier and didn’t have the feeling they had before of being the wrong sex. The evidence mentioned in the post you linked to may say otherwise, though.

    (*Some theorists posit some kind of distinction between sex/gender, but I feel that this is forced and not grounded in common usage, so I will use them interchangeably.)

    It’s hard to imagine why the expression of gender traits throughout the body would result in a male body-excluding-brain and a female brain, or vice versa. Your mind is not independent of your body.

    Regarding the acceptance of the “transsexual agenda”, by which I mean, roughly speaking, acceptance of people’s claimed genders and identities and availability of sexual-reassignment surgery, if same-sex marriage* is anything to go by, then it will prevail. Many will be uncomfortable with it, but will not speak out as loudly as its advocates. It will be treated as self-evident, despite being alien to the common experience of humanity throughout the thousands of years of history that we know about. Any who speak against it will be labelled as an ignorant bigot, despite the fact that 5 or 10 years ago, you never heard about the issue or from any of these people how there was some group in society who was being horrendously treated.

    * Or indeed, any so-called “minority-rights” campaign

  3. Your link to the article is broken. I read the whole second page before I got to the end and saw that there was another page before it.

  4. For what it’s worth, the transexuals I’ve known became a great deal happier after transition. What’s your source of information about transexuality and suicide?

  5. > It is plausible that the former is not yet possible, in the same way that there hasn’t been a cure for homosexuality.

    Actually there has been a cure for homosexuality. The rate of male homosexuality among close kin of people who died of aids is as near zero as makes no difference.

    It is plausible therefore that straight out violent repression of gender identity disorder, aka “bullying”, “Be a man, son”, would result in a major reduction of the suicide rate.

    To test this hypothesis, check if there is a higher rate of gender identity disorder related suicide among people with an enabling environment or a hostile environment.

  6. > It is plausible that the former is not yet possible, in the same way that there hasn’t been a cure for homosexuality.

    Observe the very high rate of male homosexuality in prisons and among polygynous peoples, as well as the previously mentioned very low rate of male homosexuality among close kin of those who died of aids.

    Since we are now mating primarily on the lek system, which must be producing similar effects for the majority of males as the polygynous system, it is probable that outright repression of lek mating would greatly reduce both homosexuality and gender identity disorder among males, who are the majority of those suffering from these mental diseases.

  7. Some people have minds that are broken and need treatment; respecting their autonomy too much to deliver treatment condemns them to lives full of needless and avoidable pain.

    There’s the meat of the issue. Given that someone has all the symptoms of gender dysphoria, what’s the nicest thing to do about it? Is sex reassignment surgery effective? Is therapy effective? Is it better? If so, is it enough better to warrant the use of force? (And before you ask: yes, this same line of reasoning also applies to people who believe their left arm should be gone, and to people who think demons are whispering in their ears. Why wouldn’t it?)

    Questions like “What makes one an illness and the other a lifestyle choice?” aren’t really relevant, since they’re questions about what to call something instead of what that thing is. That way lies madness.

  8. I think the reason why transsexuality offends reason is that transexuals are making a counter-factual assertion about _reality_. By contrast, homosexuals are merely making a (relatively) unusual assertion about their own _desires_. Since desires are all in the mind, and sexual desires in particular are often non-rational, the world-view of homosexuals is much easier to accept.

    If a bald man says “I don’t WANT to be bald”, that’s perfectly reasonable. If puts on a wig and says “I AM not bald”, then he is deluded. The latter is the unreasonable way that most transsexuals are currently behaving. Sex reassignment surgery is only cosmetic, and hormones delivered in adulthood are unable to reverse the sexual differentiation processes which have already taken place in the body. The result is usually a crude parody of the other sex, and I’m sure nobody is more acutely aware of that fact than the transsexuals themselves.

    But now technology has advanced to the point that the bald man has a third choice: to have a hair transplant which actually cures his baldness. And nobody objects that those follicles are not in their original positions and he is somehow still truly bald underneath.

    At some point, I have no doubt, we will be able to reactivate the genes and processes normally only active in childhood or before birth, and grow organs and body parts which are entirely integrated into the body and as functional as the ones we are born with. Of course, the driver for such techniques will be to help people who have suffered diseases or accidents, but they will also make it possible for transsexuals to finally get what they desire. And then, perhaps, many of them will discover that being the other sex doesn’t solve all their psychological problems after all, and will start addressing them in a constructive way.

    But if it becomes possible to change sex reasonably quickly, and reversibly, perhaps it won’t just be those with with problems who want to do it. Iain Banks suggested that, if we had a 250 year lifespan and a sex change process that took only a year, it would almost become conventional to try out the other sex for a decade or so, if only to get a fuller appreciation of the human condition.

  9. I read Williamson’s piece yesterday via a link from Power Line. The problem I had with it was it seemed to me that he was going a long, long way to justify what seemed like naked hatred for Manning based on the expressed gender dysphoria and not on the crimes Manning committed.

    To me, basic courtesy demands that we treat someone as they wish to be treated, as long as it does not harm another. (By direct application of the Golden Rule, the base of my atheist moral system.) What difference does it make that someone with a Y chromosome and male genitalia (and those two sets are not identical!) wishes to be treated as a female? What harm does it cause?

    The same arguments that Williamson raises can be, and are, used to justify the idea that gay men and lesbians can be treated to change their sexual orientation. That is notoriously unsuccessful. Attempts to “treat” gender dysphoria that do not involve having the patient live as the gender that they believe their minds to be are similarly unsuccessful. To me, both are in the same class of violence to the person, and both are to be abhorred. Whether my thinking on this would change in the presence of an effective treatment is an interesting, but pointless, gedankenexperiment, and one I refuse to waste time on.

    When people raise arguments against the concepts of gender dysphoria and transgenderism and homosexuality (and make no mistake, it’s nearly always the same people who do so), it’s nearly always a fancy restatement of “ewww, ick!”. One person’s disgust is not sufficient justification for violence against another.

    I know Eric well enough to know that he’s not motivated by an ick factor. (Unlike, say, the G+ commenter who complained about bathroom use.) I know that he’s trying to resolve an argument that he finds unexpectedly compelling, and do so in an intellectually honest manner. Even so, I have to disagree that libertarianism has nothing to say here, and I find that Eric doesn’t raise the argument from that angle to be a bit out of character. I have no problem with the concept that there is such a thing as a mental illness. I simply believe that a mentally competent patient has an absolute right to refuse treatment. Defining someone who is capable of understanding the condition, the treatment, the consequences of treatment, and the consequences of not being treated as mentally incompetent is simply another form of violence.

  10. 1.) There are identifiable physical differences in brain structure and behavior that occur in a significant percentage of examined self-identified transgender people. They’ve been identified in very young children who exhibit psychological signs of a gender identity disorder but lack the requisite knowledge to identify themselves as trans (mostly b/c what 5 year old even knows what a trannie is?) http://en.wikipedia.org/wiki/Causes_of_transsexualism#Brain_structure goes into it a little bit.

    2.) The higher suicide rate is sort of a chicken/egg problem. Do trannies off themselves more because they’re broken, or because being trans comes with a whole bunch of social bullshit that even gays don’t have to put up with or can avoid (it’s hard to be an in the closet trannie in any functional sense). There does seem to be a correlation between other identified mental illnesses (bipolar, etc) and trans folk, but there’s nowhere near enough evidence to draw a causal connection.

    3.) That a British NHS study found no effectiveness to genital reassignment surgery doesn’t mean it’s truth from on high. There are plenty of studies that show significant improvement in mental well being post-reassignment. The surgical techniques are also getting significantly better as time goes on. Don’t get me wrong, I wouldn’t have my dick turned inside out into a vagina, but for those that do, the available options are significantly better than they were even a decade ago. Of course, the REALLY good surgeons who perform the operation all charge a boatload of money and require cash, so maybe the NHS study is biased by their own crappy medical culture in the first place.

    4.) The way you draw the distinction between transgender folk and schizos is simple. A schizo’s perception of reality is fundamentally broken, a transgender person’s perception of reality is accurate, they just want to change it. If trans people denied the fact of their biological gender (“That’s not a penis, I just have a really engorged clit”), then they’d be like schizos. But that’s not how they behave, so they’re not. There’s no voice in their head telling them that their biological and mental genders don’t match up.

    5.) Saying you can’t trust Manning or any other trannie is a very slippery slope. Why trust anyone’s self-identification in regards to anything, if you’re going to discount trannies on the basis that their only reference is internal? Why ask someone if they’re depressed, or happy, or anything else, if the fact that we’re all only capable of experiencing things from the context of our own brains invalidates whatever we say? If transgendered people were demonstrably delusional, you might have an argument, but otherwise, the logical extension of your position is some sort of weird nega-sophistry.

    6.) If you’re going to apply this argument to trans people, you have to apply it to ANYONE who engages in ANY kind of elective body modification, pierced ears, tattoos, geeks, etc. Are you willing to do that? My guess would be no, but I’d be interested in hearing your arguments if I’m wrong.

  11. Does anyone know where to find suicide rates for trans people who have gotten hormone replacement therapy versus trans people who haven’t? Anecdata seems to point to HRT as being the great morale changer, as opposed to SRS. I’m also rather interested in Williamson’s source for the 18-20% suicide rate – numbers I’ve seen show a 16-40% attempted suicide rate, and considering the general population’s 1 suicide per 25 attempted suicides rate, a 1 in 5 actual suicide rate would be very interesting.

  12. Attempted suicides seem to be rather high in all homosexual and trans-sexual people. Even without operations.

    Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations
    http://www.tandfonline.com/doi/abs/10.1080/00918369.2011.534038

    A recent meta-analysis of 25 international population-based studies
    that measured suicidal behavior in LGB adolescents and or adults (variously defined) concluded that the lifetime prevalence of suicide attempt in gay bisexual males was about four times that of comparable hetero-sexual males (King et al., 2008).

    Based on the relatively small number of studies in this meta-analysis that included substantial numbers of women, lesbian bisexual women were found to have lifetime suicide attempt rates
    almost twice those of heterosexual women. Overall, LGB adolescents and adults were also more than twice as likely as comparable heterosexual persons to report a suicide attempt in the past 12 months.

    Attempted Suicide Among Transgender Persons
    http://www.tandfonline.com/doi/abs/10.1300/J082v51n03_04

    To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population.

  13. There’s a social dimension to it that can’t be overlooked. To wit, it is gender dysphoria, not sex dysphoria. One’s body is one’s body, in whatever state, and one’s genes are one’s genes, so sex however is empirical reality. Gender, on the other hand, is, as they say, socially constructed, a role in society; a classification rather than a class.

    Alienation from one’s assumed place in society is not always a symptom of a pathology, and while it might be said one would have to be crazy to dissent openly by claiming an identity known to be at least somewhat persecuted, that’s not the same sense of the word “crazy.” When it matters that someone believes their gender and sex to be in disagreement, then the origins of that belief should be examined, as it may not originate from a disease; when it doesn’t matter, then it’s polite to presume that it’s the product of a sound mind.

    That you mention paranoid-schizophrenics invites furthering that analogy. The belief that one is being tormented by invisible demons is not, itself, the disease; it is only a symptom. A person can be made to believe that they are being so tormented, and they needn’t be insane, only credulous. I dare say that most people could be so convinced if you can reach them before someone committed to instilling in them the (far stronger) contrary belief. Nor must it be an intentional act; parents teach their children all sorts of axioms inadvertently, and they can often go unexamined but still believed for whole lifetimes.

    I know you’re quite familiar with how hard it can be to disabuse someone of a belief from childhood, depending on how they came to believe it. In fact, the less the belief matters, the harder it is to dislodge, because you don’t have the full weight of social approbation pulling behind you. In many cases, there can be a lot of social pressure towards keeping that belief right there in place. And the whole effect is magnified further when the belief has no empirical basis at all, but is instead based on a value judgment.

    In summary, if a person believes that they know their place in society better than society itself does, then there are several further considerations. First, is this particular incidence of that belief an eccentric accident of upbringing, or a delusional symptom of mental illness (notwithstanding other comorbid conditions)? In the former case, to what extent can (or should) society tolerate such disagreement? In the latter case, does a humane treatment for the condition exist (including, if necessary, compelling it) considering also cases where treatment is in progress, fails, or is not attempted?

  14. JAD

    Aren’t you going to masturbate to your homo-traitor fantasies some more? It seems the logical thing to do.

    — Foo Quuxman

  15. You forget about the sex exception to reason, reality, and rational thought.

    Rush Limbaugh erred in the diagnosis. Sandra Fluke is a nymphomaniac, not a slut. She is practically threatening suicide if she can’t get contraceptives so her sex can be safe.

    In those same medieval times, say before 1960, people believed human beings including teens going through puberty were capable of abstaining from sex. That there was no right to have that desire gratified. And because of that, people with absolutely normal desires could remain chaste until marriage, and people with bent desires could remain chaste as well. Back then there were only 2 STDs and they were easily treated when antibiotics came along or with other drugs like Dr. Erlich’s magic bullet. Now there are over two dozen, many untreatable.

    Today, there is no requirement for any rational decision. Sex must be consensual, but it need not be a rational decision. The hypergamous woman and the Alpha. A man and a pretty young girl. No telos, end, purpose, other than gratification. And there’s abortion – do libertarians know where babies come from? If they know the consequences – a third utterly dependent human being might come into existence – do they still say this innocent party is trespassing and can be killed? He is not trespassing, he was invited.

    Hence Manning. He wants girl-sex, not boy sex. There need not be anything rational. It is about sex. He can’t be expected to control and manage his desires, that the will must pull reason above animal desires.

    Please give any other example where today even the most risky consensual sex is considered insane. The hookup and bath-house cultures are about as insane given the risks. Do you dare say so? 50 shades of gray?

    Monogamy is rational, both medically and emotionally, but that is what is sneered at and considered insane. Even Ayn Rand’s characters – the women never get pregnant or even regret anything. Or look at the single-motherhood in Detroit.

    Somehow our society has given rights to our genitals to rule over our brains.

    The brain is the seat of reason, but it is not on the highest throne. Even in if not especially in libertarian circles.

    One final proof. When asked about rational morality, the example and system given by an atheist will be about killing and theft and fraud. Simply ask for the same moral logic to apply to sex and you will hear a thunk sound as their brain shuts off and their genitals take over. They don’t want marriage or to worry about adultery. The desire must be gratified at all costs, even of their reason. But when desire overrides rationality, isn’t that insanity?

    True rationality would point to chastity, marriage, and family. But anyone even attempting to make the case will be denounced as a sexist homophobe bigot.

  16. The issue here is that just an expressed wish of being a woman is not enough to assess if you will be happy by sex reassignment. The same symptom might have several causes.

    But is undeniable that some transexuals that undergo sex reassignment have a happy and productive life after that, which they wouldn’t be able to have it without it. The counter argument is that there might be other solutions for their unhappiness, but really, who cares, sex reassignment what they felt they needed, and they are happy with that, while trying to rearrange their psychology to accept the fact they have been born with a body they don’t want, could have been a very long, painful, and possibly not successful process.

    The same happens with homosexuality, or actually, with many other choices in life. Sometimes you think you need it and sometimes you really need it, and it’s the only way, given the cards you have been dealt (by others and yourself), to enjoy life.

    And, maybe, the same happens with BIID. But with 300 cases of documented BIID, it might be hard to figure out if removing the left arm was something that really fixed the person and let him enjoy a successful life.

    When you start removing complexity from some issues, and try to label everything in terms you can comprehend, you start ignoring reality. Reality is a hairy ball of mud spaghetti, and assuming we can bag&tag everything because we are singularity men from the year 2000 is delusion.

    The reason we are at odds at trying to classify it as mental illness vs life style choice is that we can’t just infer one of the other from the simple statement ‘I want to have my sex reassigned’. And it doesn’t matter, because when those things are uttered, they are not uttered in the void. To actually decide which one it is, the process will probably be long, require a great deal from the one who uttered it, and will have a chance of failure.

  17. >For what it’s worth, the transexuals I’ve known became a great deal happier after transition. What’s your source of information about transexuality and suicide?

    The article quotes figures of 18-20%. This is in line with what I had seen in other souces but not really thought about before.

  18. Scott Alexander makes the point that people with BIID aren’t mentally ill in the same way as, say, hypochondriacs: if you chop off the limb they don’t like, they don’t then turn around and say “actually I’d like my other leg to go too, please”. If you exorcise a paranoid schizophrenic’s invisible demons, presumably they’ll just start being plagued by other hallucinations.

    On the other hand, this would predict suicide rates to fall in post-op transsexuals.

    http://slatestarcodex.com/2013/02/18/typical-mind-and-gender-identity/

  19. >There are identifiable physical differences in brain structure and behavior that occur in a significant percentage of examined self-identified transgender people.

    This is at least a start on answering the question I raised at the end of my post. However, note the followup: “In 2002, a follow-up study by Chung et al. found that significant sexual dimorphism (variation between sexes) in BSTc did not become established until adulthood.” That doesn’t sound like anything that children who lack the concept of “transsexual” can report.

    In any case we need to bear the example of phrenology in mind, and realize that it is risky to try to correlate complex behaviors with relatively gross differences in brain structure unless we have a causal account of how the difference makes a difference. It’s not quite enough to handwave and say “something sex linked is known to go on in this region”.

    >The way you draw the distinction between transgender folk and schizos is simple. A schizo’s perception of reality is fundamentally broken, a transgender person’s perception of reality is accurate, they just want to change it.

    Yes? How do we know that? To believe this you must believe that there is an objective ground of “gender identity” that invisible demons don’t have. In asserting this so confidently you’re simply assuming the conclusion.

    >Saying you can’t trust Manning or any other trannie is a very slippery slope. Why trust anyone’s self-identification in regards to anything, if you’re going to discount trannies on the basis that their only reference is internal?

    Because usually such reports are consistent with behaviors that make people happy and functional. When they aren’t – for example, “Alcohol is good for me” from a wasted derelict who has lost his friends and family and has serious brain lesions showing in an MRI – you have to start questioning whether the report is valid or a sign of deranged cognition. Again, consider BIID in this regard.

    >If you’re going to apply this argument to trans people, you have to apply it to ANYONE who engages in ANY kind of elective body modification, pierced ears, tattoos, geeks, etc. Are you willing to do that? My guess would be no, but I’d be interested in hearing your arguments if I’m wrong.

    These modifications aren’t even remotely in the same category as BIID or gender reassignment, being mostly reversible and involving little or no loss of options. They don’t raise anything like the same issues.

  20. Let’s be specific here. The article says this about suicide rates:

    Dr. James Bellringer, a British physician who has performed hundreds of sex-reassignment surgeries at the Charing Cross Hospital gender-identity clinic, points out in defense of the practice that about one-fifth of those who are denied the procedure attempt suicide; but a study conducted by the British National Health Service found practically identical — 18 percent — suicide-attempt rates for those who had undergone the procedure.

    This is some distance from “The objective check is that acting on this belief doesn’t seem to reduce their suicide rates significantly.” If nothing else, consider the difference between the cohort of those who are denied the procedure and the cohort of those who do not have the procedure; it should be fairly obvious that the latter must be larger. If you’re willing to be critical about the article, consider the difference between a formal study and “a doctor says.” Consider also the fallacy of looking at numbers for one country and assuming they apply generally.

    And, of course, there’s no link to the NHS study so we have no way of looking at it critically. I found a Philadelphia based study from 2005, but it does not distinguish between the cohort of those who’ve had gender reassignment surgery and those who haven’t.

    Seriously, when you read an article in a highly ideological publication, whether it’s the National Review or DailyKOS, you’ve got to drill down into it, because there’s a strong likelihood that the author will have allowed their confirmation bias to creep in either consciously or unconsciously.

  21. I wrote:
    >In any case we need to bear the example of phrenology in mind, and realize that it is risky to try to correlate complex behaviors with relatively gross differences in brain structure unless we have a causal account of how the difference makes a difference.

    I should note here that I have personal reason to be a bit suspicious about theories tying transsexualism to individual female-typical brain structures in males. When I was in college I was put through a psychometric battery by a neuropsychologist who, after observing my behavior, formed a theory that I have a female-typical corpus callosum. The technology to look didn’t exist yet, but I understood the ground of his theory and it was in fact a reasonable inference from what he could observe. Still would be today.

    But me, gender-dysphoric? Um, no. Not ever, not even remotely. To whatever extent the concept of psychological “gender identity” is meaningful, mine as a male seems to be quite solid, perhaps exceptionally so. Thus my skepticism.

  22. Eric, exceptional masculinity is a reasonably strong tell for a compensation mechanism for female brain in male body in cultures that have a “warrior tradition.” It has roots going back to the Spartans, had parallels in the Maori and most of the Indian tribes of the Algonquin nation.

    The REALLY vicious fighters combined the aggression and physical capacity of the male with the utter “take no prisoners, these are my children at risk” vindictiveness of the female…except expanding the mental locus of “children” to “tribe” or “culture.” The other tendency they have is that they tend to form groups of people to get things done…and then step aside from the leadership roles, because the leadership role makes them deeply uncomfortable, and worried about the price of hubris.

    Is this sounding familiar at all?

    The number of US SOCOM operators who, after serving their stint, identify as trans is absurdly high. Chris (now Kristin) Beck is the first high profile case, and she’s high profile because she got to a high enough rank to draw a pension and be noticeable about it.

    http://www.telegraph.co.uk/news/worldnews/northamerica/usa/10098727/First-transgender-US-Navy-SEAL-tells-her-story.html

    Talk to Hedgemage about this – I have fewer contacts in the SOCOM community and they’re older than hers – but both she and I noticed that gender dysmorphia becomes increasingly prevalent the farther up the “asskicking ranks” you go in the US military. There are a lot of signs of it that she can articulate better than I can, but it’s a mix of hypercompetence in the field, coupled with utter and complete disinterest in the usual male methods of blowing off steam: Getting drunk, carousing, etc. They’ll still get laid – the acronym is “GMATATS” – Get More Ass Than A Toilet Seat.” and they have no real interest in sex with men, even after reassignment and hormone therapy. (All of the happy trans folk I met were better described as “lesbians male bodies” rather than “women in male bodies.”)

    I’ve known, in round numbers, an order of magnitude more trans people than you have. I suspect you’ve known about twice as many as you think you do – because the ones who are successful at it really do blend in.

    Why do I know about ~60 of them? One of the OTHER odd trends among those who identify as trans is that they have an absurdly higher incidence of IQs 2 to 3 standard deviations above the norm.

    The way I’ve had it described to me is that it’s a balky set of drivers sending frotzed up inputs. You can function with it, and one way to function with gender dysmorphia as a male with crossed up wiring is to become the most kick-ass specimen of warrior-ethos masculinity you can possibly be.

    The 300 at Thermopylae. Horatius at the Bridge.

    So, to answer your question:

    Is there a way to determine that they’re other than a “doesn’t acknowledge reality/self-harming” crazy? Yes, observe their behavior and ability to function in society. The three societies I pointed to at the top of this essay (Sparta, Moari culture, the Agonquin nation) aren’t really our “Squishy Wishy Washy Touchy Feely Western Culture.” These people were highly effective in their cultures. Their cultures made a role for them.

    One of the people I game with, Mere, is about 6’4″, 250 lbs, and has to shave twice a day to avoid “sudden onset beard” popping out on her face; signs and symptoms of the odd brain wiring show up in body language and posture. If you look at how she moves kinematically, yeah, it’s all the tells of femininity, and not the “exaggerated drag queen” variety – in the body and frame of someone who, if they worked out, would’ve been a decent college level defensive end.

  23. >This is some distance from “The objective check is that acting on this belief doesn’t seem to reduce their suicide rates significantly.”

    Sorry, I’m not seeing it. A British surgeon says about 1/5th of transsexuals denied reassignment surgery suicide; the NMS says 18% of those that get it suicide. Where’s the “some distance” here?

    You say “If nothing else, consider the difference between the cohort of those who are denied the procedure and the cohort of those who do not have the procedure; it should be fairly obvious that the latter must be larger,” but in a single-payer system like the NHS that’s not obvious at all.

    Bellringer, as “a British physician who has performed hundreds of sex-reassignment surgeries” can be safely presumed to know a lot about the post-operative complications. I don’t think you can safely write his report off as anecdote.

    In any case, both figures are comparable to statistics I’ve seen in other sources. I just hadn’t happened to think through the implications before.

  24. Ken, the one MtF TG person I know is ex-military, and vague recollection says that she was some form of special operator. She fits your profile very well indeed.

  25. I also came here to link to Scott’s article.

    In the comments, there are people identifying as strongly cis. Alas, none give a detailed explaination of what it feals like, but it seems that visceral gender identity is a thing.

  26. Y’also need to keep in mind that you’re measuring these people against a cultural backdrop of not just majority male genital mutilation alone, but under unconstitutionally sex-specific bans against female genital mutilation, as well as the outright industrial commoditization of the erogenous flesh of male children.

    If you’re going to talk about this kind of gender dysmorphia, it’s blatant denial — and I mean that clinically — to so conspicuously ignore the impact of not only genitally mutilating the majority of half the population by gender, but doing so at the point in life literally most likely to cause massively damaging permanent psychological imprints.

  27. Pingback: Crazies and Social Acceptance Thereof | Something Fishy

  28. >Is this sounding familiar at all?

    Of course. You are, as you are well aware, describing me – even to the detail that ex-SOCOM people have made me as a plausible SOCOM candidate if not for my CP. I have no reason to disagree with them, and given what I do for fun it would be damn silly of me to try.

    The trouble with this theory is that it predicts that I should be gender-dysphoric, and I’m simply not. I’ve never had fantasies about being a woman, and I like having a penis just fine. This makes me suspicious of glib talk about “compensation” – it sounds like Freudian mythologizing to me. What would I be compensating for? Having a female-typical corpus callosum isn’t a bug, it’s a feature.

    As a thought experiment, I spent a few minutes trying to imagine being a woman (having a female sensorium, kinesics, genitalia, etc.; wearing womens’ clothing, using female speech patterns). If I had some kind of lurking gender dyphoria I suppose this would feel either liberating or very threatening; in fact it just felt awkward and silly. Not me.

    So, data point: I fit your profile, but I’m not gender-dysphoric. Your theory is underdetermining.

    > These people were highly effective in their cultures. Their cultures made a role for them.

    Agreed. But they didn’t lop their own genitals off, either – and such behavior was not unknown in pre-industrial cultures, see priests of Cybele etcetera. I find it far more likely that these historical hyper-warriors were more like me – possibly equipped with some individual female-typical brain structures, but not gender-dysphoric in any meaningful psychological or social sense.

    I think you’re theorizing way beyond the evidence bere. SOCOM is a very stressful environment; it seems at least as plausible to me that it drives lots of people crazy, and as usual crazy is modulated through forms of deviance and self-harm that are currently fashionable.

  29. I think the biggest difference is that we can all agree that being an amputee is worse than being intact – cutting off limbs doesn’t actually do you any good, and it’s not a normal or proper state of being. Conversely, being a woman isn’t inherently worse than being a man. It’s easy to tell someone they’re better off with two arms than one, but who’s to say that being a woman is inferior? (Admittedly, they can’t quite get all the way there, but looking a bit funny and being infertile is well within societal norms)

  30. >Conversely, being a woman isn’t inherently worse than being a man.

    Huh? How did we get so fixated on MtFs here? The relevent question, for females as ewell as males is whether you’re better off with your genitalia amputated and a clumsy, mainly cosmetic “sex change”.

  31. ESR: “One of the stupidest possible counters is also probably the most common one: if you don’t accept transsexuals’ reports of their own condition, you’re being nasty and unfeeling to them. Um, OK, how does this apply to paranoids?”

    In my opinion there is a big difference between transsexuals and paranoid schizophrenics. The delusion transsexuals suffer only induces them to have painful and unusual things done to their own bodies. Paranoid schizophrenics’ delusions are not so limited.

    But the thing that jumps out at me the most strongly from this discussion and the articles I’ve read is that, to the extent transsexuality is still considered a mental illness, there is no clear path on how to treat it, or even on how best to enable transsexual people to fit in with a gendered society. That’s a more important issue than just saying that it’s abnormal to amputate sexual parts.

  32. > Paranoid schizophrenics’ delusions are not so limited.

    Agreed, but to reason about Williamson’s argument we need consider only the set of delusional psychotics who mutilate themselves but are not dangerous to others. The existence of psychotics who want to mutilate other people is not relevant.

  33. ESR: “A British surgeon says about 1/5th of transsexuals denied reassignment surgery suicide; the NMS says 18% of those that get it suicide. Where’s the “some distance” here?”

    The problem is that we can’t assume that the number of people in each group is the same. We don’t know the total number of transsexuals denied surgery, or the total number of transsexuals who finally *get* surgery–let alone how either subset compares to the number of transsexuals as a whole. (And I’m ignoring, for simplicity’s sake, the possibility that British transsexuals may or may not be different in relevant respects that transsexuals elsewhere, since the British surgeon likely is talkind about transsexuals in the British population.)

    If the population of transsexuals that are *denied* reassignment surgery is much larger than the population of transsexuals that *get* reassignment surgery, there may well be many more people committing suicide among the “denied” group than among the “obtained” group, even though the *percentage” of suicides is the same. And in any event, the fact that the suicide rates are that high emphasizes that we don’t have the right tools to help transsexual people yet.

  34. I, for one, belong in a body that does not over a period of decades weaken, lose its ability to heal, and eventually destroy itself. And it sometimes pains me to think about how my body is, probably, not quite up to that standard. I imagine most of you have some sympathy for this condition.

    Anyway, let’s hope technology advances to the point where we can all happily indulge our desires to have whatever kinds of bodies we want, in risk-free, reversible fashion.

    The question is then what do we do in the meantime, with people who are unsatisfied with the bodies they have. I suppose that, essentially, they should decide whether they can do anything about it, and if not (if treating it is too expensive or impossible with current technology or just too terrible), they should stop worrying about it (at least until some future point when conditions might have changed). If it continually bothers them, gets on their mind, and makes them unhappy, even though they’ve decided there’s nothing they can do (or nothing further they can do) about it at the moment, then I suppose that could be classified as mental illness–that sounds like an obviously-true definition of a class of mental illnesses, actually.

    But then, note that if someone’s mind is set up so that when they’re being repeatedly mistreated by someone else, it continually bothers them, gets on their mind, and makes them unhappy… then such a person might by this process (a) become motivated to fight back and perhaps win against their malefactor, or (b) become depressed and become useless as a slave. People like this would probably more often revolt against tyrants and stop bullies; conquering them would be less profitable and likely less feasible. If there were a lot of people like this around, there might be fewer tyrants in power and less personal mistreatment. And this may have worked better in the past (some people say that technology makes it harder for people to overthrow a government today; eh, perhaps). So that seems like a trait you might like to have around, perhaps one you’d admire. Should it still be called an illness? ……. Arguably, yes. But now the concept of “illness” seems to get divorced from “we’d like to cure it as widely as possible”.

    Then there are probably various cases of technologists being motivated to develop an excellent treatment or cure for some problem because they, or a loved one, had that problem and it kept bothering them. … Now, this isn’t to say that people suffering is good–the point is to get that problem solved. It’s just that it motivates them… … But then, why not just have them consider the whole situation rationally and let them decide? Isn’t that strictly better than having them suffer as well? Do I have a point here? … Yes, I do. There is a thing:

    It is likely to be difficult for the technologist to capture all the benefit-to-humanity they create by making the solution. (It is also likely to seem difficult. Perhaps you can create a profitable company around your solution and become rich, but you may not know that beforehand.) It seems plausible that, rationally, we’d have a situation where [benefit to everyone of sol'n] > [cost to technologist of sol'n] > [benefit to technologist of sol'n]: what some would call a public-goods problem. However, if we now imagine that the technologist, personally, suffers excessively from the problem, then that may change the situation to [benefit to technologist of sol'n] > [cost to technologist of sol'n]. Then the technologist will do it, and everyone will be glad and admire him. Interestingly, this is similar to the above case: one particular person participating in a revolution against a tyrant seems likely to lose more than he gains, even if we feel sure that the dispersed benefits to everyone greatly outweigh the costs.

    (And the idea of admiring them for it comes up again. I think that “doing something where the benefits to everyone outweigh the costs to everyone, but where the costs to the actor would appear to outweigh the benefits to the actor if the actor were a “normal” person” is as good an operational definition of “heroism” as any. [Actually I wrote approximately this in an 8th grade essay, except for the subtlety about a "normal" person.] And admiration and maybe gratitude are appropriate towards heroes.)

    I do think technology and the general advancement of humanity should make it easier to solve “public-good problem”s–e.g. massively crowdsourced funding of a cure to some minor but very common ailment. However, in the meantime, we may have to rely on some people’s inability to “cope” with a problem. And here I have echoed my lead-in… it appears that one type of individual-human weakness (which we should eventually grow out of) may compensate for an organizational weakness of the species (which we should also eventually grow out of).

    So. First, do no harm. Yes, indeed. Inculcating general-purpose coping skills into everybody may have some undesirable consequences: people may become more meek and domitable, and one source of entrepreneurship may be lost, at a first survey. So, what? Well, help a friend cope (or learn to cope) if it seems like a good idea in their case, but don’t generally make it a mission, evangelize it, and tell people there’s something wrong with them if they don’t want to learn to be stoic or to numb themselves or something. [Essentially, the above meandering may be interpreted as partially fleshing out the reality that the cautionary principle leads us to expect to exist.] And, of course, aggressive force is right out, unless you really think you know what you’re doing [and are prepared to accept retribution from civilized people for it].

  35. >The problem is that we can’t assume that the number of people in each group is the same.

    This isn’t normally considered a problem in reasoning about incidence unless the sample size of one or both groups is very small. Since Bellringer reports having performed “hundreds” of surgeries, and the denied group is probably larger, it seems highly unlikely that this is the case.

    The way epidemiologists thing about this sort of thing is that the severity of a pathogen, disorder, or environmental stressor is normally expressed by incidence rates in vulnerable populations – the assumption is that body counts will scale up linearly as the size of vulnerable populations increase.

    So, yes. those suicide rates really are comparable. Unless you have some reason to throw out the linear scaling assumption in this case.

  36. I do think libertarianism is relevant here.

    “Mind own business, always cut cards.”

    “Are they transgender or are they crazy?” is really asking “Should I believe them and let them do their thing, or treat them like they’re delusional?” And really, really, almost always, I believe that individuals know best about their own situations. If they’re not a danger to themselves or others, unless they’re seeking help/advice/critique, it’s basically *never* a good idea to tell people to totally rearrange their lives because of your opinion.

    And I strongly oppose the practice of opining on “society” generally. Should “we” have so much casual sex? Should “we” stop objectifying women? Pop music these days is terrible, “we” should listen to better stuff. Um, there is no “we.” There is you and the people you influence. Actions are taken individually, not collectively.

    “Should there be transgender people? Should ‘we’ treat them like they’re mentally ill?” It’s a wrong question. There *are* transgender people, like it or not. And I certainly don’t have enough information to determine what all the ideal policies would be with respect to the phenomenon. In the meantime, I mind my own business, treat people decently, and default to taking people’s word about their own experiences.

    That said, sometimes it’s not socially acceptable to say “I prefer X so that’s what I’ll do,” but it is acceptable to say “I *need* X, I’ll be in pain without X, I am unable to function without X, I have a doctor’s note that says I have a sickness that means I need X, I have a disadvantage that means I need X.” And I don’t like that pattern. Admittedly, sometimes the “need” stories are obviously true. But I suspect that when “need” is acceptable but “prefer” is not, that encourages and worsens dysfunction. Contemporary society definitely medicalizes being trans. I’ll see, for instance, statements that body dysmorphia is evidence that transgender identity is real. Which is a statement of the form “It’s all right to do X if and only if you suffer pain in the absence of X.” When that is the social script, you *get more pain.*

  37. ###
    This is at least a start on answering the question I raised at the end of my post. However, note the followup: “In 2002, a follow-up study by Chung et al. found that significant sexual dimorphism (variation between sexes) in BSTc did not become established until adulthood.” That doesn’t sound like anything that children who lack the concept of “transsexual” can report.
    ###

    Oh, maybe I was unclear, the wiki link was just for generic bio-chemical causes of transgender expression, not specifically the bit about the kids. A quick Google search for “transgender children MRI” seems to provide more specific information about that particular phenomenon. Anyway, the point is, there’s at least a hint of a physiological source of transgender.

    ###
    In any case we need to bear the example of phrenology in mind, and realize that it is risky to try to correlate complex behaviors with relatively gross differences in brain structure unless we have a causal account of how the difference makes a difference. It’s not quite enough to handwave and say “something sex linked is known to go on in this region”.
    ###

    Really, phrenology? Do I actually have to list out the reasons why that’s a bad comparison to the argument I’m making, or can we just assume that we both know the difference between correlation and causation?

    ###
    Yes? How do we know that? To believe this you must believe that there is an objective ground of “gender identity” that invisible demons don’t have. In asserting this so confidently you’re simply assuming the conclusion.
    ###

    Did you not read the second half of that paragraph, where I gave an example? I don’t have to assume an objective ground of “gender identity”, the fact that transgender people don’t deny the reality of their biological gender is enough. We’re talking about comparing them to schizos, who have very easily identifiable delusions about what reality is (not being able to tell the voices aren’t real, etc.), those delusions about _objective_ things like which sex chromosome you have don’t exist in people who are trans.

    ###
    Because usually such reports are consistent with behaviors that make people happy and functional. When they aren’t – for example, “Alcohol is good for me” from a wasted derelict who has lost his friends and family and has serious brain lesions showing in an MRI – you have to start questioning whether the report is valid or a sign of deranged cognition. Again, consider BIID in this regard.
    ###

    Yeah, and for a lot of trans people, taking transitional action makes them happier and more functional. Transgender people _don’t_ have serious lesions in their brain, and their social situations probably aren’t any worse than they were for gays 40 or 50 years ago. Is your family shunning you b/c you’re a trannie any different or less destructive than having your family shun you because you’re gay? Yet we’re not questioning whether or not to let a guy suck a dick if he wants to.

    ###
    These modifications aren’t even remotely in the same category as BIID or gender reassignment, being mostly reversible and involving little or no loss of options. They don’t raise anything like the same issues.
    ###

    1.) Actually, gender reassignment surgery is sort of reversible.
    1a.) There’re prosthetics for BIID folk who regret their decision after the fact.
    2.) http://upload.wikimedia.org/wikipedia/commons/0/08/Enigma01.jpg – Tell me that’s reversible and doesn’t constrain options.
    3.) What’s the bright line you want to draw where body modification suddenly requires a greater level of ethical/legal scrutiny before it can be performed? I don’t think you’ll be able to come up with one that isn’t arbitrary AND doesn’t make more or less “normal” procedures suddenly indicative of a potential mental health problem.

  38. >Huh? How did we get so fixated on MtFs here?

    Sorry, I thought the “without loss of generality” was implied.

    >The relevent question, for females as ewell as males is whether you’re better off with your genitalia amputated and a clumsy, mainly cosmetic “sex change”.

    This sounds like it’s more a concern about the quality of the procedure than it is about the concept of it.

  39. Re: the assertion that the high rate of suicide among post-op transsexuals (which I have not observed, but I tend toward a pretty stable social circle, so I don’t encounter suicide outside my volunteer work much) indicates that therapy, not transition, is the right course of action:

    Is anyone comparing this to the rates of suicide among those who *don’t* transition? Doubtful, because until someone seeks transition, they are generally unknown to the medical machinery as transsexual.

    I don’t actually have stats at hand (and frankly don’t know that they were collected in the first place), but I would be *shocked* if there were not times and places in history where homosexuals had similar suicide rates. Being a social outcast to the point of suffering systemic discrimination, corrective violence, losing one’s family, being unable to find gainful employment, and so on — *especially* because of something deeply rooted in one’s identity — puts one at high risk for suicide. There is also an extremely high risk for suicide in having a serious, undiagnosed, unacknowledged long-term illness, and many trans* folks go years without knowing that their condition has a name or that treatment is possible.

    Also, there’s a dangerous cultural meme in the trans community that transition will magically “fix” everything. It’s not that simple. Being trans doesn’t mean you have no other problems, and transition doesn’t mean you will be instantly accepted as your newly-assigned gender by others. Learning the hard way that life isn’t instantly perfect can be traumatic.

    As for the comparison with paranoid schizophrenia WRT not being able to confirm from the outside: We can *disprove* the schizophrenic from the outside — see that there are no alien spiders under the bed, scan the body for implants by evil spy agencies, and so on — not so with gender identity disorder.

    GID presents a lot like many other non-gender types of severe body dysphoria, which suggests that similar disconnects are at work.

    Additionally, many trans* folks have demonstrable physical causes to their problems: I know one FtM whose mother was subjected to an ill-conceived testosterone treatment while he was in utero. I know three who have genetic abnormalities on their X or Y chromosomes (or too many of one or the other, etc.). I know two others with severe hormonal conditions. It stands to reason that there may be physical causes for transsexuality that we simply don’t know how to diagnose yet.

    If you’ve ever watched someone go on/off sex-related hormone therapy, it’s a sight to behold. At this point, those providing treatment to transsexuals have come to see hormone therapy as not just a treatment, but also as a diagnostic tool. Some few people go on it and have an immediate “this is wrong” reaction…they seek other help for their problems and go off the hormones. Others experience a profound sense that the world is re-aligning to be “more right”, and it shows in their behavior just as profoundly as getting a schizophrenic onto the right psych med does. They become more stable, more functional, less stressed, and so on…even in the midst of the profound physical and emotional changes that hormone therapy brings about. I care about *what works*, and for those it fits, trasition *works*.

    Schizophrenia inevitably prevents the sufferer from functioning in the world without treatment. However, trans* folks are often remarkably functional, not just in mediocre lives but in extremely high-stress roles such as SOCOM, civilian emergency response, SWAT, and so on.

    In addition to all this, and regardless of the value judgements some would like to make, psychological gender is a lot more resilient to manipulation than physical sex. Go read up on the cases of botched circumcisions or other medical accidents causing well-meaning medical practitioners to reassign boys *at birth*, parents who raised their “little girls” from the start to be girls, and how those children inevitably grew up believing they were boys and traumatized by what had been done to them.

    There was a time when it was believed that homosexuals should be “reformed” through psychological conditioning. Thankfully, that time has passed. It’s passing now for transsexual folks, too, and I’m glad. Transition — for those who are good candidates, and we’re getting better at picking them out — is real help.

  40. > The trouble with this theory is that it predicts that I should be gender-dysphoric, and I’m simply not.

    Your logic is severely broken.

    “Many gender-dysphoric people tend toward hypermasculine ass-kickery such as careers in SOCOM and the like.”

    DOES NOT IMPLY THAT

    “All people with the psychological predisposition toward hypermasculine ass-kickery such as careers in SOCOM are gender-dysphoric.”

  41. > The relevent question, for females as well as males is whether you’re better off with your genitalia amputated and a clumsy, mainly cosmetic “sex change”.

    SRS is only one facet of transition (either MtF or FtM) and arguably not the most important one. I know several transgender people who pursued transition but did not undergo SRS due to medical or other concerns, yet still got a lot out of the process. It’s highly individual.

    Transition also (and first, before SRS is considered) includes hormone therapy, living in the new gender role and seeking social situations in which one will actually be treated that way. It involves sharing one’s identity with others so that one’s outward image and internal understanding of self can come into sync.

    Also, why do you assume that SRS is “clumsy” and “mainly cosmetic”? Have you ever gotten a close look at post-SRS genitalia? The tech is pretty impressive. Most trans people I know well enough to discuss such things with had more sexual function and were more able to enjoy sex after SRS than before. Only one had a difficult/dangerous physical recovery, and she had underlying medical conditions bad enough that *any* surgery was high-risk.

  42. I’ve known three people pre-and-post transition with HRT; two were former US Military and SOCOM. While they were military, they were as “happily male” as anyone you’d ever know. Once they got out of the military, the reinforcements and buttressing on a constructed identity fell apart…one nearly slit his wrists rather than admit that, yeah, 8 years in Special Forces was an elaborate self-deception on gender identity.

    Once he became a she, HRT and all…they became vastly happier. In every way, shape or form. Especially since “becoming a she” and still liking chicks wasn’t “becoming queer.” (The permutations of that mental process still leave my head spinning…

    (I was her “do I like guys” experiment after SRS. The short answer was “No, not really.”)

  43. Sorry, I’m not seeing it. A British surgeon says about 1/5th of transsexuals denied reassignment surgery suicide; the NMS says 18% of those that get it suicide. Where’s the “some distance” here?

    You say “If nothing else, consider the difference between the cohort of those who are denied the procedure and the cohort of those who do not have the procedure; it should be fairly obvious that the latter must be larger,” but in a single-payer system like the NHS that’s not obvious at all.

    No. You’ve got no evidence that everyone who might want the procedure applies for the procedure. That is different from saying that everyone who applies for the procedure is considered. The latter can be presumed accurate in a single-payer system. The former cannot.

    “I want it, but I’d lose my job.”
    “I want it, but my parents would be disappointed.”

    Anyhow. Really nice set of comments, HedgeMage, thank you.

  44. I used to believe that gender was just something people made up out of very little. I’d still like to believe it, and there’s certainly more overlap between men and women than those who believe in Male and Female seem to imply.

    However, the existence of gender dysphoria tells me that there’s some strong stuff going on about gender roles and physiological gender, stronger than I would have guessed.

    One way I have of understanding the situation is that I have reliable physical comfort with being female*, even though I’m not interested in a lot of what goes culturally with being female. I can extrapolate that if someone were as discontented with their birth gender as I am content with mine, they’d be pretty unhappy, and it seems plausible that it could get a lot worse than that. Why not believe people who say they’re miserable in their birth gender when they’re visibly so much happier when they switch over?

    I’ve poked around a bit online about suicide among transsexuals, and the alternate explanation is that it’s a result of being badly treated. This seems plausible.

    I’ve met someone who was deeply unhappy about living in an organic body. They’ve got it worse than transsexuals do. More generally, I know enough about various maladies to believe that anything about the human body can’t be expected to work reliably in everyone.

    *I can imagine being comfortable with being male, but it’s not something that haunts me. If sex reversal were cheap, safe, convenient, and reversible, it’s something I might want to try out.

  45. Jay Maynard on 2013-08-24 at 07:44:10 said:
    > The same arguments that Williamson raises can be, and are, used to justify the idea that gay men and lesbians can be treated to change their sexual orientation. That is notoriously unsuccessful.

    And, similarly, Zimmerman “notoriously misjudged” Trayvon by profiling him as a drug addled burglar.

  46. esr on 2013-08-24 at 13:02:35 said:
    > Huh? How did we get so fixated on MtFs here?

    Males pretending to be females is far more problematic and more common than females pretending to be males.

    Or perhaps it is less common, and we simply do not pay much attention to females pretending to be males because less problematic, less drama ensues. Not sure which it is.

  47. First, I learned three new words in the OP. Thank you, Eric.

    Don’t know if this point of view helps, but gender confusion (or rejection) is a mutation in the evolutionary development of our species. It’s hard to see how this aberration could persist enough to reinforce the survive and thrive imperative, and ultimately become a trait.

    Is there an overweening social benefit to accommodating (via surgery) this particular aberrant psychology? In other words, is it wise to artificially propagate an evolutionary mutation with little hope of advancing the species?

  48. > Males pretending to be females is far more problematic and more common than females pretending to be males.

    Our culture has social templates (which mostly don’t suck) for female-bodied people taking up male appearance, behavior patterns, and social roles. The same is not true for male-bodied people taking up female appearance, behavior patterns, and social roles.

    If similar templates existed for male-bodied folks with female social leanings, I expect that only those transwomen with nontrivial body dysphoria issues would seek transition, and those whose impetus was primarily social wouldn’t identify as trans at all, but as whatever equivalent to a tomboy arose.

  49. Sorry, JAD, but you’re simply wrong: there is no evidence at all that treatment to change a person’s sexual orientation has ever worked. Even the practitioners of such therapies – those that aren’t either blinded by their religion or cynically making money from those who cannot accept a gay loved one – are accepting that it doesn’t work. Remember Exodus International?

    Personally, I don’t think it will be possible to change someone’s sexual orientation until we understand one hell of a lot more about how the brain works. I also think that’s a smaller change than changing the sexual identity someone holds for themselves. I’m not sure it will be possible even then. It damned sure isn’t possible now.

  50. James A Donald you scare me – I would avoid you and never introduce you to my children; If you really believe bullying is appropriate.

    Methods of achieving trans sexuality should be questioned! Native American tribes had Trans people called berdache but, never believed in amputation and that was ok for their community until colonization.. So, what I think I am seeing is people grasping at aesthetics through a medical field to attain that same communal acceptance or social status… Perhaps it is not so much a mental disorder so much as a community one — Far to the root as I can tell this is a matter of understanding deviation from community agenda; perhaps homogeneous inclination vs. Pluralism.

    I say this as I believe Judith Butler makes note in Undoing Gender – Gender Reassignment surgery is consistently a matter of privilege so, inherently – I doubt surgery is the root amelioration as one not need be a historian to know Gender Reassignment Surgery not existing at one time or another. Consider David Reimer’s sexual reassignment – though it be one case it be startling.

    Personally, I find the surgery radical and pervasive a symbol of change and sex education made tangible… Also, barbaric and pitiable given that I see it not addressing underlying issues of prejudice and generational cookie cutter natalist tendencies. At times I worry Gender Reassignment Surgery serves as a perfunctory cover to achieve one desired physically perceived status within some communities rather than address the community at large to reduce perceived necessitation of such surgeries.

    Additionally have you seen a prosthetic penis with a hand pump? I just… I think the documentary I saw – the man with that could not find a spouse. So, David Reimer killed himself when his spouse left him too if I read accurately.

    Anyway! JAMES A DONALD I SCOLD YOU!?! I cannot believe you are serious! So, lol OR! If I take what you write seriously –
    Stonewall Riots were the answer towards police “bullying.” It seems a bit base, narrow, and uncivilized to believe bullying is the means to resolution.
    >.> SO quit it! :D xD :D ~~~~~~~~~~<3 :D

  51. I’m a bit nervous about poking the bear like this, but…

    JAD, exactly how are “males pretending to be females” problematic?

  52. > exactly how are “males pretending to be females” problematic?

    It’s pretty problematic for them. The social penalties in our culture for male showing doing things perceived as feminine are *exceedingly* high, whereas women like me who do a lot of things perceived as masculine will at worse get shrugged off as tomboys or assumed to be lesbians even if we aren’t. More often, we’re seen as strong, “breaking barriers” (gag), and to some people damn sexy. Plus, everyone wants the kickass tomboy on their team because then they get to show how “woman friendly” they are without having to pander to the obnoxious victim card wenches.

  53. There’s also the fact that aside from below-the-waist plumbing, FTM transsexuals are much more convincing than MTF transsexuals without additional surgery. High testosterone levels trigger irreversible secondary sex characteristics including male pattern bone growth and density, deeper voice and thicker, coarser body hair. FTMs develop these with a testosterone regimen, whereas MTFs can’t reverse what they have if they transition late (though face feminization and depilation surgeries can help cosmetically).

  54. To evaluate treatments just look at the conditional probabilities (with reassignment, or without). There’s a disturbing trend of ressentiment thinking pushing the erosion of peoples’ ability to rank things. For example, homosexuality clearly ranks below heterosexuality, but there is a great deal of effort being put into convincing people that it is a perfectly normal, healthy option. We seem to jump between horrific and unnecessary abuse of certain types of people to nonsense about all attributes and choices being equal. People seem to have trouble remembering that, for example, being a homosexual is a small fraction of a person’s personality. So you can say “homosexuality is a negative attribute” without it being implied that “homosexuals are all net-negative people”.

  55. >So, yes. those suicide rates really are comparable. Unless you have some reason to throw out the ;inear scaling assumption in this case.

    They’re not comparable because the treatment group has various selections applied to it. One way this could bias your result is if the surgery is made more available to more desperate cases, which could increase the number of suicides in the treatment group *pre-treatment*. What you have to do is first apply all the qualification tests for reassignment, then from the group that qualifies *randomly* divide into people who will get the treatment and people who won’t. Then you still have placebo problems..

  56. @Roger Phillips:

    I don’t think that anyone has argued or would argue that having one’s body and brain disagree on ones sex/gender is anything but undesirable. The discussion seems to be whether manipulating the body until it conforms to the brain, or manipulating the brain until it conforms to the body is the better approach.

    My observation (and I’ve been around a lot of trans* folks in my day) is that, while there are people for whom sex/gender issues need something other than transition, transition (altering the physical body to match the brain gender) is a huge net win for some people. Meanwhile, changing someone’s gender identity…I’ve not only never seen it work, but what I know about psychology and gender suggests that it generally *can’t* work.

    I’m also very, very skeptical of the ~20% post-SRS suicide rate that ESR cited, as it does not match my observations or what I’ve learned from others more educated in the subject than I. However, I haven’t challenged it because there may well be something about how transition is handled in the UK or their social dynamics WRT gender that I don’t understand, as my experience and observations are nearly 100% limited to the US.

  57. >I don’t think that anyone has argued or would argue that having one’s body and brain disagree on ones sex/gender is anything but undesirable. The discussion seems to be whether manipulating the body until it conforms to the brain, or manipulating the brain until it conforms to the body is the better approach.

    The comment you’re replying to was (confusingly) intended as a general comment on the trend of Western society to level, not addressing the thread directly. And there are people who have argued that, for example, a person taking hormone pills who says they are a “woman” is in fact, a woman. And perhaps if a man goes far enough he really can be a woman. But there have to be requirements or the category “woman” would have no power of resolution (clearly untrue). This at odds with the trends, which are to say that everyone (or, a growing list of people) has to right to “be what they want” and to be thought of in a positive light. But in fact, we got this far by discriminating between and ranking people.

  58. I don’t have time right now to read all the comments, so I apologize if someone else brought this up. Williamson says that about 1/4 of people who actually take the final step of surgery wind up changing their minds eventually and want to revert. I actually heard an interview many years ago on the radio with a person who’d done just that, and she (I believe it was a woman who changed to male and then back) said that the result of the two surgeries is not pleasant. ISTM that if 25% or so of people who want to do something this major wind up thinking they made a mistake, then it’s a step that needs to be considered more thoroughly before undertaking, because it’s not something that’s going to be easy to undo.

  59. @Rick C: ” ISTM that if 25% or so of people who want to do something this major wind up thinking they made a mistake, then it’s a step that needs to be considered more thoroughly before undertaking, because it’s not something that’s going to be easy to undo.”

    This is a good point, and I’ve seen it raised on websites directed to advising transsexual persons, but it is a bit tangential to the main issue being discussed here, which is whether sexual reassignment surgery is ever an approrpriate treatment in the first place.

  60. “I’m also very, very skeptical of the ~20% post-SRS suicide rate that ESR cited, as it does not match my observations or what I’ve learned from others more educated in the subject than I.”

    Going back to the linked article, it seems this is a suicide attempt rate. I’m not sure how this mutated in an actual suicide rate in this thread

  61. I think that if people want to change or remove their bits and pieces, that should be up to them regardless of the suicide rate. Even better if it’s well studied and the ‘one in five will check out early’ stat is clearly explained to them beforehand, so that they know the chances that they will still be depressed as hell are pretty good.

    If you were a depressed trans, the surgery might be something you look forward to as something that will finally make you happy – the same way that some people think that having a child will make their life great somehow and then it doesn’t turn out that way.

    Possibly, the only reason they haven’t committed suicide already is the hope that surgery will make things better. Things don’t get better, hence the suicide stats. (if they are good stats, I haven’t looked into it either. Health stats tend to pretty dodgy in general.) If there was no surgery option, suicide might have occurred a lot earlier.

    Maybe I’m taking things a bit further than the usual libertarians here, but I think people should be free to transition, commit suicide, chop off their limbs, believe in demons possessing their body etc.

    But libertarian respect for autonomy cannot entirely banish the concept of mental illness either.

    Well, surely it can until the point that someone starts becoming a threat to other people? Maybe there’s some kind of case that can be made for preventing people from harming themselves, but gender transition seems to be pretty far towards the acceptable side of that line, to me.

  62. Faggotry aside – what do you actually feel about Bradley’s revelations? I mean this whole “sex side” of the story looks too much like an attempt to divert attention from war crimes he has exposed.

  63. A note on suicide rates:
    Perhaps the fact that transgender people suffer from greater violence, are more likely to experience sexual assault and have to put up with a level of vitriol which is frankly astounding might have something to do with that.
    For example, Lucy Meadows was hounded by ther particularly vile Daily Mail. So bad was this, she took her own life.
    Or one of the nicest, and cleverest, people I know was forced out of university when she took the decision to transition. Thankfully she didn’t let this stop her.

    I won’t get into sex and gender except to say that there are plenty of trans activist out there who can provide great explanations of the issues.

  64. Oh, and I forgot to say – sex reassignment therapy is not necessarily surgery (which is what most people seem to assume for some reason)

  65. It seems like a great deal of the talk here is predicated on assumptions that this or that objectively determinable statistic cited is either true or not true. I don’t actually care that much about trans this or that. It’s something that is not particularly in my experience and it’s not a problem I have to deal with at the moment. I deeply care about handwaving reality to fit preconceptions or ideology because that causes a great deal of trouble up to and including mass casualty events to try to make reality fit.

    Reality is. Wouldn’t the first order of business be to figure out what it is and reason from there?

  66. I’m hesitant to reason from “the suicide rate does not change” to “reassignment doesn’t help” because reassignment correlates with a confounding factor, namely emerging from the closet. If we were to restrict our sample only to transsexuals who were already “out” before they decided on reassignment, perhaps we would find a change in the suicide rate.

  67. @esr:

    So, yes. those suicide rates really are comparable. Unless you have some reason to throw out the linear scaling assumption in this case.

    It seems entirely likely that the scaling is not linear, but in the other direction — the most suicidal would have killed themselves before they had a chance to get “fixed.” A comparable suicide level in denied vs. allowed might actually mean that going through the surgery makes you *more* suicidal.

  68. Does a libertarian view point even need to include a theory of mental illness? The idea that one person or the state can declare someone mentally unfit for freedom and incarcerate them indefinitely into a state funded institution doesn’t lend itself to libertarian ideals…

    Nymphomania and homosexuality were also once considered mental illness. That was in an age where sane and fair treatment for mental illness included lobotomies, electroshock therapy. Today those diagnosis are considered discriminatory and the treatments considered inhumane, right or wrong was this sort of treatment an effective allocation of public resources?

    Whether or not transgender urges are a sign of a malfunctioning brain/body is irrelevant to the larger question of whether or not society should force or deny treatment. If there is a demand for mental illness treatment? A free market would allow for the supply. If there is a demand for sex changes, a free market would allow for the supply. As soon as we remove other peoples money from these equations, someones strange donkey sex fetish become much more tolerable.

  69. > people who want to amputate the genitals they were born with

    The argument might be coherent, but that doesn’t matter because the premise is false. Transsexuals are not people who want to amputate their genitals. That would actually be a special case of BIID. Transsexual people merely desire strongly to change their sex.

    Then an authority figure comes along and states that the recommended treatment is surgery, which is quite different than coming up with surgery ideas on your own. So no matter how many transsexuals have the surgery performed, we don’t know why they did. The percentage unhappy with the result is pretty good evidence that it’s the doctors’s promise of improvement that causes people to have it, and that the surgery itself is perceived as a necessary evil based on the recommendation.

    The rest of the article focuses on how transsexuals have difficulties to cope with societal artifacts that seperate people along gender lines. It also states that, somehow, this is evidence of pathology. This is stated as fact, but it is just an opinion, nothing more.

    As for having a coherent theory of mental illness, there has never been any such thing. Occam’s razor would suggest we should therefore drop the idea entirely. A pretty good candidate for replacement would be, in the opinion of the commenter, to simply judge behavior based on the very Libertarian NAP. So if I chose to believe that Jesus died for my sins, and that literally eating him at a congregation will improve my spiritual worth, it is not necessary to judge whether or not those ideas are correct. It is merely necessarily to judge whether the behavior that I exhibit is neutral or beneficial to others.

    That would make things much easier for transsexuals, and it would then no longer be necessary for their supporters to come with any particular psychological theory at all. It would merely be necessary to figure out how we can help them pick a restroom. There are quite practical issues at hand; a very feminine man or cross-dresser is at equal or greater risk to be harrassed by a group of men in a vulnerable situation, while there is very little risk of a group of women being harrassed by a single very feminine man. Perhaps new signs should be used for restrooms for “primitive cavemen” and “gentle people”. In any case, there is nothing inevitable tying genetic sex to our passports and where we freshen up.

    But, changing society is hard. So we just go on dreaming up new excuses why things have to stay how they are. Thanks for nothing, Kevin.

  70. I found Eric’s post thought provoking, but where I come back to always is that if someone does want to modify their body then that is their business. People make all sorts of regrettable body modifications that they might later regret. The gal who gets a full back tattoo of a dragon wrapped around “Tyrone is my lover” might quickly regret it when Tyrone takes his dragon elsewhere.

    Of course chopping off a limb is a rather more serious matter, as is chopping off one’s dick. I imagine any serious medical professional would require some pretty serious counseling of the patient before engaging in such a procedure.

    The real question is autonomy and freedom of will. I don’t doubt there are times when it is necessary to say “this person is incapable of exercising judgement on their own behalf, therefore we have to transfer those choices to someone else.” But if that doesn’t scare the crap out of you, I don’t know what would. I’d rather a few limbless, dickless folks with big regrets than granting such an arbitrary power to nasty, nasty people; and make us all wake up feeling robbed not just our or dicks, breasts or right arms, but of our whole personhood and autonomy.

    It makes me thing about the state and kids. Th arbitrary power the state has to take kids away from their parents is utterly terrifying, even though clearly someone has to rescue some kids from the very worst of parents. It is an inponderable, for sure.

    Whether the arm chopper off crowd can find a suitably qualified doctor to do the chopping is another question. Obviously the dick choppers have a specific agenda though.

  71. “””What makes one an illness and the other a lifestyle choice?”””

    Just a nitpick – calling it (or e.g. being gay) a “choice” is the conservative position (after all, if you can choose to, you can choose not to). As far as I know, the standard liberal position is that it is an illness whose best remedy is to get a sex-change operation. I do realize that this doesn’t take away from the point you’re making in that statement.

  72. >Your logic is severely broken.

    No, I’m just a bit more familiar with Ken’s favorite kinds of argumentation than you are. He wasn’t merely tagging me as a random example of the population likely to have dysphoria, he was suggesting that I’m one of the extreme examples for which the Bayesian implication is that I would almost certainly have dysphoria if his model is correct. You will notice that he did not object to my counter as you did.

    With a little effort either Ken or I could write out the chain of conditional probabilities for you.

  73. @ esr
    As other commenters have pointed out, leaving your libertarianism at the door on this one makes your argument (to the extent you have one) vulnerable to several forms of challenge that you really should have foreseen.

    For example – if your (or Williamson’s?) conclusion is that people who identify as transsexual should be denied treatment including surgery, then who is it that implements the denial?

    Granted, in a transactional economy where the professions regulate themselves without State interference, the guild of doctors might forbid its members from providing such treatment. The likely result is that a person who sought the treatment would need to purchase it from an outlying practitioner who was either not admitted to the guild or was willing to work outside its authority.

    This seems unlikely to provide an individual seeking treatment with much certainty of quality or outcome – which would seem to bring your libertarian theory and practice to a point of acute conflict.

  74. Patrick Maupin: What do you think of my adverse selection idea? This would tilt the suicide rates in the other direction.

  75. @ Patrick Maupin

    It seems entirely likely that the scaling is not linear, but in the other direction — the most suicidal would have killed themselves before they had a chance to get “fixed.” A comparable suicide level in denied vs. allowed might actually mean that going through the surgery makes you *more* suicidal.

    I think that this has already been touched on before, but I can suggest a reason why going through the surgery makes a person *more* suicidal.

    A trans person is depressed, but sees and wants an apparent solution – the surgery. After the surgery the person discovers that the depression is still there but now there is no clear solution in sight. Then they commit suicide.

  76. @ Fluffy Girl – “dick choppers”

    In what other blog can you find references to dick choppers and alien shit zombies? And have it be relevant, intellectually stimulating, and enlightening.

  77. Any thoughts on Blanchard’s typology for transsexuals? (https://en.wikipedia.org/wiki/Blanchard%27s_transsexualism_typology)

    Whether or not this typology has any merit, it does at least suggest (to me) an interesting criterion to try. That is, a young male just entering (or prior to) puberty, with unusually “feminine” characteristics, a slight build, etc, who is also attracted to males, and who identifies more with the female sex, may actually live a *better* life as a MtF trans woman than as a homosexual male. That is, may experience more social acceptance, have an easier time acquiring desired sex partners, etc. This sort of candidate for hormones + surgery may perhaps be distinguished from someone who “feels like a woman” inside, or who otherwise desires to be a woman, but whose life would demonstrably be better off if he were to continue living as a man.

    In short, an interesting criterion is whether the candidate’s sexual and social life is likely to be improved. And, Blanchard’s typology might suggest that these roughly correlate with different inward experiences and thus different impeti for one’s desire for the hormones and operation.

  78. Seems to me that in a great many cases we are seeing status competition. \

    In the lefter than thou race, women outrank men, and gain substantial privileged by so doing – for example the difference between SAT and GPA indicates that being female gets one’s grade inflated.

    But homosexuals outrank women, and similarly get privileges over women and males.

    And if a heterosexual white male, the bottommost rank, the lowest status, the most persecuted group, claims to be a lesbian trapped in a man’s body, he then outranks homosexuals.

    In at least some cases, the noisiest cases, the most publicity seeking cases, the most obnoxious cases, looks to me that they are doing it primarily for the high status.

    In high schools in high socioeconomic status districts, the students have created an elaborate apparatus for faking up a history of left wing activism to put on one’s college application.

    Next step, for those particularly eager to entrance to a prestigious university, is to cut off their dicks.

  79. I wrote:
    > In the lefter than thou race, women outrank men, and gain substantial privileged by so doing – for example the difference between SAT and GPA indicates that being female gets one’s grade inflated.

    Another indication of female grade inflation, is that when women are put into tough courses on the basis of their GPA, they are apt to struggle relative to males with the supposedly same GPA, and wind up eventually switching to a course in stupid after piling up college debt.

  80. Ayep,

    >blatant denial

    it is.

    So much for all your conceited moral status posturing.

  81. Above I posted some reviews of stats on attempted suicides of homosexuals and transgenders. They were held back in the moderation cue. Real suicides where there is definite data on preferences seem to be too rare to make sense of the causes.

    Has anyone here wondered whether suicide attempts of transgenders are higher than other people with minority choices in sexual preferences?

    If you are a homosexual or transgender and happen to be surrounded by people like JAD, life could easily lose its appeal.

  82. >In any case, there is nothing inevitable tying genetic sex to our passports and where we freshen up.

    The question is not whether it is inevitable, but whether it is desirable or useful to do so. And there is immense utility to separating along gender lines. For example, in an emergency where fast action is required, you can get a bunch of men to do things with the minimum amount arguing because it is drilled into them from birth that they need to act during a crisis. Of course, the process of leveling has eroded this enormously, so now cowards can be “equal” to heroes and we all lose out. All brought to you courtesy of the ressentiment of lesser creatures (and nuclear weapons). The burden of evidence is upon interventionists, not traditionalists.

    >But, changing society is hard. So we just go on dreaming up new excuses why things have to stay how they are. Thanks for nothing, Kevin.

    As opposed to.. what? Changing a working system for the benefit of some insignificant minority? This is the classic interventionist point of view: you know better than thousands of years of cultural experimentation, so let’s throw a bunch of stuff out for the sake of your own bleeding heart. There’s a word for this: degeneracy.

  83. I am not sure what the Wicca attitude toward reincarnation is.

    As soon as you take the reincarnation hypothesis into account, transgender does not seem to indicate any serious psychic disturbance anymore, but just a “bug” (in the IT sense) during the reincarnation process.

    And such “bug” is not really more serious than when someone has a strong desire to fly planes or go to the sea since an early age, even though unprompted by parents.

    Note that Indian society, which more or less accepts reincarnation as a viable possibility, is very tolerant to transgender people, up to the willingness to register them as third-sex into official population registers.

  84. To add something to my previous comment.

    How does the feeling of being transgendered develop during life? Is it common that someone develops transgenderism at, say, 26? Or do the majority of cases emerge already in childhood and persevere through the entire life?

    If the latter, and if you took the reincarnation hypothesis into account, the explanation with a “bug” in the reincarnation process would be actually stronger.

  85. @Jay Maynard

    “To me, basic courtesy demands that we treat someone as they wish to be treated, as long as it does not harm another.”

    OK, then I think I’d like to get treated like a Nobel prize winner + kick-box champion. A bit of royal blood would be nice, too, can’t everybody just call me Your Highness?

    My point is, people should not expect others to treat them in unrealistic ways, as a something as they definitely are not. Of course in case of gender where do we draw the line of what is realistic is debatable – it could be entirely defensible to say that a bona fide effort to look and behave like one gender is enough.

    In other words, there ought to be a social consensus regarding how people can qualify to any given social category of being.

  86. @shenpen
    You do not understand the meaning of concept of “courtesy”?

  87. @Winter on 2013-08-26 at 09:15:37

    At some point honesty and practicality override courtesy. It’s OK to humor somebody who claims to be Napoleon Bonaparte, until he wants you to join the march to Moscow.

  88. There is a minority view within the homosexual community that many (most?) cases of transsexualism are significantly influenced by deeply internalized homophobia. This school of thought belfries that the appropriate therapy is psychological therapy to help the patient come to terms with his (or her) being homosexual (and effeminate if male or butch if female, because even among homosexuals, accepting oneself being that way isn’t a given). There’s a prominent advocate of that position who’s name I’m not remembering who has received a lot of flak for expressing that view.

  89. @TomA
    > In what other blog can you find references to dick choppers and alien shit zombies?

    Oh btw “Dick Choppers” is a very unfair characterization (that I made.) The operation is very sophisticated and quite fascinating to watch. You should all check it out, YouTube can facilitate that.

  90. @Roger Phillips:

    What do you think of my adverse selection idea? This would tilt the suicide rates in the other direction.

    I agree the data could support that mechanism at some level. I think we’re all in agreement that more data is needed before you can reach a definitive conclusion one way or the other, but that, as a first pass, “the suicide rate didn’t significantly change” appears to be a valid starting statement. I think we’re probably also all in agreement that 20% is waaayyy above any kind of normal baseline.

    And to tie this back to topics from earlier posts — how many of these people were diagnosed with depression and prescribed the kind of drugs that shake you out of your stupor and give you enough energy to kill yourself ?

  91. Bryant:
    This is some distance from “The objective check is that acting on this belief doesn’t seem to reduce their suicide rates significantly.” If nothing else, consider the difference between the cohort of those who are denied the procedure and the cohort of those who do not have the procedure; it should be fairly obvious that the latter must be larger.

    True, but this moves the result in the opposite direction to where you seem to want it to move. The cohort of those who don’t have the procedure must indeed be larger than that of those denied it; but the suicide rate among that larger cohort must be lower than that among the smaller one. So instead of 20% v 18%, which is close enough for the difference to be a statistical artifact, but is still a visible difference, it might well be 18% v 18% or even 17% v 18%! It certainly can’t be 21% v 18%.

    ESR:
    You say “If nothing else, consider the difference between the cohort of those who are denied the procedure and the cohort of those who do not have the procedure; it should be fairly obvious that the latter must be larger,” but in a single-payer system like the NHS that’s not obvious at all.

    It seems obvious to me. Regardless of who pays, it has to be true that there exist people who might be candidates for the surgery but who don’t apply and are thus not denied. Those denied surgery are a subset of those who don’t have it (leaving out entirely, of course, those who have no interest in it!). But as I pointed out above, that subset must surely have a higher suicide rate than those who didn’t apply, and thus adding the latter will lower the total suicide rate for the untreated.

  92. @ Fluffy Girl – “You should all check it out”

    I think I would prefer watching a PSA titled “A dick is a terrible thing to waste.”

  93. ESR: I must support the criticism of the suicide stats as well. There is substantial self-selection bias involved in the people who select for sex-reassignment surgery. Sadly, placebo-controlled studies are especially difficult to do with this.

    Marian Kechlibar: To argue from 4th-hand anecdote, one published tale I read about involved a person who can remember from the age of 5 asking her parents when she would get her penis, and feeling that something was missing.

    Cathy: I suspect that the 1/4 of people who decide to reverse occur in-part because there isn’t a way for patients to know ahead what things will be like afterwards without experiencing it. After all, most interventions are designed to take things back to the way that they were or to stop a very physically painful condition. For something which is more in the consciousness, they may discover that surgery takes them too far or in the wrong direction.

  94. “How is Bradley Manning’s expressed belief that he is a woman trapped in a man’s body epistemically distinguishable from a paranoid schizophrenic’s belief…”

    I’ve heard this argument before, that those suffering from gender dysphoria are delusional. I think you are taking literally statements that are meant metaphorically. I have a son who is dealing with gender dysphoria and wants to start taking hormones and eventually have sex reassignment surgery. I can reassure you that he does not think he is a woman in a man’s body; rather, he has a brain that is expecting a female body, he feels more comfortable in a female social role, and he finds himself repulsed by his masculine body.

    Furthermore, whether we should call gender dysphoria a mental ilness or not is beside the point; what matters is what’s the most effective way of helping those who suffer the misery of gender dysphoria. As far as I can tell, there is no known mental therapy that is effective in resolving gender dysphoria. Hormone treatment or sex reassignment surgery may be the best we can currently do for them. At the very least, I can say that my son has gone from deeply depressed and even suicidal to a much more positive frame of mind since he has been able to openly dress as a woman and have some limited hormone treatments.

  95. Jay Maynard on 2013-08-24 at 07:44:10 said:

    “… the crimes Manning committed.”

    From a libertarian perspective, I don’t think you can say that Manning committed any crime. What he did was make known the grave crimes that people in government had committed.

  96. Marian Kelchibar said: As soon as you take the reincarnation hypothesis into account, transgender does not seem to indicate any serious psychic disturbance anymore, but just a “bug” (in the IT sense) during the reincarnation process.

    Yeah, and when you take the invisible demon hypothesis into account, the paranoid schizophrenic also doesn’t seem crazy anymore – just someone really plagued by invisible demons.

    Is the problem with “as soon as you take this utterly evidence-lacking hypothesis into account” apparent yet?

  97. Oh btw “Dick Choppers” is a very unfair characterization (that I made.) The operation is very sophisticated and quite fascinating to watch. You should all check it out, YouTube can facilitate that.

    Uh, yeah, I think I’ll pass. MtFs must be either very brave or very desperate; I’m to understand that there’s a considerable amount of pain involved with transition after the surgery itself is complete. The stories I’ve heard were enough to convince me that the brain’s being confused over which body it was installed in, and dysphoria over finding itself in the “wrong” body, is a real, actual thing. Even if it weren’t… well, to pick a pathological example, if Face McShooty really wants to be shot in the face, who are we to question his desires, if he passes every test of having such a desire?

  98. @Ken:
    >The number of US SOCOM operators who, after serving their stint, identify as trans is absurdly high. Chris (now Kristin) Beck is the first high profile case, and she’s high profile because she got to a high enough rank to draw a pension and be noticeable about it.

    But is this because they really are female brains in male bodies and try to be hypermasculine to try to hide that? Might it just be that they’re male brains in male bodies that have, by familial or peer pressure, been indoctrinated with an unrealistically high standard of masculinity (and/or one that conflates certain non-sex-linked traits with masculinity), and, finding themselves unable to meet that standard, conclude that their inability to meet it must be a result of being a female brain in a male body and give up on trying to be male?

    >Why do I know about ~60 of them? One of the OTHER odd trends among those who identify as trans is that they have an absurdly higher incidence of IQs 2 to 3 standard deviations above the norm.

    But is the high IQ the result of feminine brain structure, or does high IQ cause an otherwise typical male to exhibit behaviours that fall short of cultural or personal standards of masculinity, possibly causing hypermasculinity as an attempt to compensate, followed by despair about ever being able to be masculine enough and the conclusion that if one cannot be masculine enough, it must be the result of being female-brained, followed by transgenderism?

    High IQ could cause this by allowing a male to perceive that certain behaviours associated with masculinity (either because having a Y chromosome actually causes such behaviours or because the are culturally/stereotypicaly male) are bad ideas, or by otherwise causing shifts in the risks and rewards perceived for those behaviours. Less intelligent males might perceive the resulting reduction in propensity to engage in those behaviours as a deficit in masculinity worthy of mockery.

  99. This is an issue with a lot of hard cases and few good answers.

    My take:

    Gender dysphoria is real. It is a “mental illness”; that is, a mental condition which is wrong. It is not a delusiion but a neurological condition. BIID is analogous, and some of the neurological basis of BIID has recently been uncovered.

    The brain has wiring for gender identity. If that wiring is wrong, GD results.

    Evidence for this brain wiring: the Reimer case. Bruce Reimer was a Canadian infant whose penis was destroyed in a bungled medical circumcision. Under the influence of sexologist John Money, his parents tried to raise him as a girl. (The remains of his genitals were removed.) This failed: despite adult pressure and the lack of male parts, “Brenda” always knew he was a boy. When his parents finally told him the truth, he said “Ah! I’m not crazy!” and became as much of a male as possible. (Money built a career around claims of success in the case, which was hailed by feminists as proof that gender roles were “socially constructed”.)

    What else? There seems to be a fair number of little boys who want to act feminine (1/1000 ?). Many of these boys stop spontaneously, I have read of therapies which cure them of these tendencies, but are rather forceful. (One involved aversion with mild electric shocks.) Others, apparently, learn to hide these tendencies, but are internally unhappy, reach adulthood, and “come out” as TS.

    This creates a dilemma. A TS, especially an MfF, can make a much more convincing and (presumably) successful transition by starting before full puberty. Some clearly want to, and for those whose GD is intractable, this might be the best solution.

    But transition is unquestionably worse than successful acceptance of the physical gender. For those who don’t require transition, it’s a horrible imposition – something that would be utterly wrong to do to a child.

    And at this time, I don’t think the categories can be distinguished.

    What else? There are males who fetishize female sexual attributes and want to embody them (autogynephilia). Many of these fetishists pretend to be gender dysphoric to enforce acceptance of their practice. That muddies the waters a lot.

    What else? The confusion between male homosexuality and GD is a major factor in some societies. The Ayatollahs (starting with Khomeini) are wholly on board with MfF transsexuality and Iran has more SRS cases than any other country except Thailand. By decree the surgery is almost free. However, it’s fairly clear that a lot of the cases are homosexuals evading the very severe laws against that.

    What else? There is a small but non-trivial number of people whose physical gender is ambiguous – chromosomal anomalies such as XXY, or conditions such as Androgen Insensitivity Syndrome. In Complete AIS, a person with XY chromosomes grows up with a complete female external habitus – breasts, no body hair, female genitals, The syndrome is often detected at puberty, when the person never menstruates, and a gynecologist discovers there’s nothing inside. There are about 8,000 CAIS cases in the US.

  100. No true libertarian would question another person’s self-diagnosis. Out loud, at least.

    Which does not mean that anybody should get a conversion at taxpayer expense.

  101. Ken Burnside: 60 transsexuals, or 60 former SOCOM veterans who are transsexuals? Both claims seem extraordinary – the latter very extraordinary.

    (I have personally met 5 transsexuals, two I knew well, and have seen two others at several cons. One of the five was an almost convincing MtF – which put her right in “uncanny valley”. 60? I if I tried to list every personal acquaintance I’ve had in the last 10 years, I don’t think I would reach 1,000.)

  102. > there is no evidence at all that treatment to change a person’s sexual orientation has ever worked. Even the practitioners of such therapies – those that aren’t either blinded by their religion or cynically making money from those who cannot accept a gay loved one – are accepting that it doesn’t work.

    Or perhaps they are accepting that they will be sent to jail if they keep on saying that it does work.

  103. “Or perhaps they are accepting that they will be sent to jail if they keep on saying that it does work.”

    You are talking about a restriction on speech, entirely separate from a restriction on continuing their practice. This is an extraordinary claim. There’s nothing stopping people from saying, if they believed it, “It worked fine, but the big bad government told me to stop so I stopped. Write your congressperson.”

  104. Or perhaps they are accepting that they will be sent to jail if they keep on saying that it does work.

    I hear they do that if you keep on saying things that aren’t true. They keep mumbling something about proffesional ethics… whatever the hell that is.

  105. Why do so many libertarians completely miss the point – “personal choice” blah-blah-blah – bullshit!

    Deciding if you would wear trousers today is a personal choice. Changing gender will also change your role in society – the most obvious example is parenting. So no, as long as your “personal choice” will affect your interactions with other society members it’s no longer so personal anymore.

    Smocking is personal – only until you decide to do that in a bus full of other people.

  106. > > “Or perhaps they are accepting that they will be sent to jail if they keep on saying that it does work.”

    Random832 on 2013-08-27 at 03:22:59 said:
    > You are talking about a restriction on speech, entirely separate from a restriction on continuing their practice.

    There are a large, and rapidly increasing, number of restrictions on speech, just as there are on guns. Originally the supremes said that they were restricting commercial speech, but were going to be really protective of political speech. They then decided that right wing political speech about current elections was commercial even if no money or quid pro quo was involved, as Kirk Shelmerdine discovered.

    Disagreeing with the authorities on medical practice is effectively illegal for medical practitioners, thus if you are vaguely involved in something that can plausibly be called medicine, for example selling vitamins, it is illegal to say that homosexuality is treatable, just as it is highly illegal for real estate agents to give you a plain English answer about demographic trends. (Try asking one. If you press for a plain English answer, or interpret his doubletalk answer into plain English, he will suspect you of being an agent of the authority trying to entrap so that he can be punished for thought crimes.)

    There are also a lot of restrictions on speech about financial matters.

  107. if you are vaguely involved in something that can plausibly be called medicine, for example selling vitamins, it is illegal to say that homosexuality is treatable

    [citation needed]

  108. Anthony on 2013-08-26 at 10:38:51 said:
    > There is a minority view…that many (most?) cases of transsexualism are significantly influenced by deeply internalized homophobia.

    I’ve seen no evidence of this. As a matter of fact, I’ve seen a big pile of anecdotal evidence to the contrary: I’ve almost never run into a homophobic trans person, and many of the trans folks I know are bisexual. I know very few who changed what sex partners they pursued during or after transition, and those who did were flighty 20-somethings still in the college-and-experimentation phase of life.

  109. @BobW on 2013-08-26 at 10:24:38

    “Believing I’m Napoleon doesn’t make me crazy. It makes me Transhistorical!”

  110. I’ve only known 1 or 2 transsexuals, and only briefly. I have, however, explored the internet side of this part of humanity quite a bit.

    My opinion of how they got to their situation (a near-adult or adult who wants to be the opposite sex) is that nearly all transsexuals harbor unresolved humiliation from their parents or someone who raised them.

    Shame is about the most powerful disruptor of child development there is. Many people do not learn how to deal with feelings of humiliation until they are well past young adulthood. Shaming is a powerful tool that parents and grandparents use to rear children into adults. Think about it, the first time anyone is shamed is probably over running around naked when they “shouldn’t be”. The earliest experiences most people (raised in the U.S.) have with shame is shame over our own naked bodies. Grandparents show up for a visit, little bobby is having a fantastic time running around without any pants on, and suddenly he gets a serious, even icy glare from the grandparents who ordinarily offer him hugs. It is probably the first time an adult has looked at him like that, particularly from one who has only openly expressed affection before. The mental trauma is extreme for a young child, their minds probably go into overdrive trying to figure out what is different that made an adult figure treat them in such a way. Ultimately nudity becomes a shame-bound condition that significant chunks of the American population will go to all kinds of mental-gymnastic-displays to avoid and further shame others who engage in it. You could say that the whole of America suffers from childhood trauma that perpetuates the puritanism of 400+ years ago.

    Now what happens if the earliest and/or most powerful childhood experiences with shame are directed towards the child’s sex? Lets suppose that Bobby’s first erection is shamed by his mother, what is he supposed to feel about his genitals then? What if Jennie keeps hearing from her father that he wishes she had been born a man, or feels the effects of chronic shame from her father that she “cant do” what guys can do early in her life?

    In my mind, transsexualism is most often unresolved childhood shaming from parents who fundamentally failed to prevent their own (many times sexual) hangups from affecting their child’s self-assessment of their own gender. Adults who want surgery to correct their gender “mistake” are most likely the same children who were never able to resolve their own parents disapproval of their sex.

    I realize how this makes me sound, but I believe it to be the fundamental truth that is not spoken of. I have yet to find anyone who can prove me wrong.

  111. Josh on 2013-08-27 at 05:59:39 said:
    > Changing gender will also change your role in society – the most obvious example is parenting. So no, as long as your “personal choice” will affect your interactions with other society members it’s no longer so personal anymore.

    I’ve changed my role in society a bunch of times. I’ve moved up and down the economic ladder. I’ve gone from student to teacher and back again. I’ve married and divorced. I’ve become a parent. I’ve become an aunt. Apart from the marriage and the aunt thing, I never asked anyone’s permission nor should I have. It’s my life: hang out and play along, or don’t.

    You imply an overestimation of the influence of a parent’s sex/gender on parenting. For good parents, the sex/gender of the *child* dictates how they parent, not their own sex/gender. I’ve seen some incredibly awesome, incredibly masculine men don tutus and tiaras with their little girls. I’ve likewise seen women a lot more feminine than I take up martial arts or motocross to get closer to their little boys.

    Why is it that growing up female in a rural, conservative, Catholic town and nonetheless getting into martial arts, hacking, backpacking/survival, emergency management/search and rescue, motocross (not that I was very good at that one), leather craft, and so on, I’m seen as “breaking barriers” or somesuch nonsense, while a male-bodied person wanting a feminine social role is seen as suspect?

  112. @Jeremy

    It would be a hard thing to (dis)prove at all. However, I’ve seen a great deal of anecdotal evidence to the contrary:

    * MtF transwomen who were raised in cultures/subcultures where it was *far* better to be male and maleness was celebrated.

    * Trans* folks whose gender mismatch was obvious long before even the earliest signs of puberty.

    * Lots of kids damaged (I’ve done volunteer work with abused/traumatized kids and at-risk populations) by parents’ weird ideas by sex/gender — they not only outnumbered trans* people by far, but had distinctly different psychologies.

    So, I’d need to see evidence sufficient to outweigh all of that before I’d consider your theory credible. As you’ve given absolutely no supporting argument for the conjecture, I stand thoroughly unconvinced.

  113. Everyone’s journey in life is unique: highs/lows, knowns/unknowns, danger/refuge, bumps, wild left-turns, and strange attractors. You play the hand your dealt. CP hasn’t held Eric back, and experiencing gender dysphoria should likewise be viewed as another challenge in life, not a deal killer. Libertarians say “fine – deal with it”; just don’t make me pay for the surgery if that’s your choice. This discussion is well and good, but Williamson’s original article was more of a meme attack on Manning than a legitimate discourse on transgenderism.

    Moral of the story – no one promised you a rose garden.

  114. @HedgeMage
    It would be a hard thing to (dis)prove at all.

    Oh, I agree. I won’t pretend my comment should be taken as scientific.

    * MtF transwomen who were raised in cultures/subcultures where it was *far* better to be male and maleness was celebrated.

    Even in such cultures, I can imagine childhood shame happening at just the wrong time and never being corrected. I wouldn’t say this is anecdotal evidence to the contrary. More importantly, I would expect such cultures to be far less equipped to understand the damage that is done, or recognize the behaviors that cause such damage. Why? Because maleness is associated with being tough and disposable, so early psychological damage in boys is far more often overlooked.

    * Trans* folks whose gender mismatch was obvious long before even the earliest signs of puberty.

    I would presume this would help confirm my thinking, not contradict it. Why would you think this anecdote contradicts me?

    * Lots of kids damaged (I’ve done volunteer work with abused/traumatized kids and at-risk populations) by parents’ weird ideas by sex/gender — they not only outnumbered trans* people by far, but had distinctly different psychologies.

    That’s fine, but how many of those kids damage was damage directed at *what* the child is as opposed to behavior? There’s a big difference between being damaged through bad behavioral feedback, and being shamed *for what you are*. I would expect that there would be far more kids damaged by the occasional walking into mom-and-dads room while they’re having sex or being discovered while touching themselves than there would be kids who by contrast internalized mom’s prudishness as meaning that having a penis is wrong.

  115. Jeremy on 2013-08-27 at 11:33:08 said:
    [...]
    > Even in such [male-centric] cultures, I can imagine childhood
    > shame happening at just the wrong time and never being
    > corrected.
    [...]
    > I would expect that there would be far more kids damaged by the
    > occasional walking into mom-and-dads room while they’re having
    > sex or being discovered while touching themselves than there
    > would be kids who by contrast internalized mom’s prudishness as
    > meaning that having a penis is wrong.

    You seem to think that small children are *far* more fragile than
    they are. The mere fact that the trans* population is so small
    indicates that being trans* isn’t the result of something as
    nearly-universal in our culture as having prudish parents.

    It takes *intense* abuse — the likes of which I won’t describe
    here — to cause kids to have gender-identity issues. Even
    repeated rape won’t do it. Sex/gender identity is one of those
    things that is so central to how people live and mate that if it
    were as easily disrupted as you suggest, we’d have died out
    ages ago.

    –Susan

  116. I really think you’re looking at the suicide rate from the wrong perspective. I imagine having surgery or not bears little relevance on the trans suicide rate. I would imagine social support versus social isolation and ostracization would be far more predictive. Transsexuality is more about social role than physical body per se. Surgery won’t change how your social contacts treat you. Those whose families hate and reject them before surgery will hate and reject them after surgery. People with accepting, supportive friends and family before surgery will have them after.

  117. >I imagine having surgery or not bears little relevance on the trans suicide rate.

    I think that’s probably true – which makes the theory and beliefs behind the surgery more questionable, not less.

  118. Whose “theory and beliefs behind the surgery”? Kevin Williamson’s?

    We all recognize that turning yourself into a cat or having a limb amputated takes you outside of societal norms. On the other hand, no one seriously questions the sanity of someone who has an enormous nose when they get a nose job to make it look normal. No one says a woman with A cups who gets augmentation to become a C cup is crazy. No one says a man who has surgery to correct gynecomastia is a freak. Nor does anyone fault a woman with an extremely large clitoris from having it surgically reduced to an average size. With SRS, we’re not talking about procedures to take their bodies outside social norms. Once you accept a person socially as the opposite gender, all the procedures become strictly cosmetic, having the effect of aligning them physically with the social norms of their chosen social roles. This is the exact opposite of turning yourself into a cat.

  119. Rick Rostrum:

    I’ve known about 60 trans people in the last 30ish years. Most MtF, a handful FtM. For one of the MtFs, I was her “do I like guys” experiment after her surgery.

    I’ve known four SOCOM operators who came out as trans.

    Not all trans* people want surgery or hormone replacement. I’ve had at least four different plausible explanations for what goes on; for a lot of trans people the “software/hardware stack” mismatch starts before puberty, gets worse during puberty and they compensate. I don’t think there’s anything about being SOCOM that causes people to snap and say “I want to be a woman.”

    I think that a lot of very bright, very driven people get pulled into SOCOM, and a larger incidence rate of them being trans* is the consequence. The common points I’ve found in the sample set I’ve known is that they’re usually bright, very detail oriented, and, well, driven. Compensation-monsters all of them.

  120. @HedgeMage

    You seem to think that small children are *far* more fragile than
    they are. The mere fact that the trans* population is so small
    indicates that being trans* isn’t the result of something as
    nearly-universal in our culture as having prudish parents.

    Aren’t they? When we’re speaking of small children, we’re speaking of blank slates that absorb all kinds of interaction with the people/world around them. I’m wouldn’t be so silly as to pretend that any single interaction “breaks” a child, as if it is possible to never re-mould clay after you mess it up. But it only takes one or two bad encounters that are then never corrected/contradicted by people who love the kid to influence the kid into a bad frame of mind nearly permanently. The damage is likely something that 99% of parents would never recognize. This sort of event in happens in all sorts of ways in peoples lives that the field of psychology acknowledges and attempts to provide treatment for, why would being trans be any different?

    It takes *intense* abuse — the likes of which I won’t describe
    here — to cause kids to have gender-identity issues.

    While I don’t necessarily agree that it takes “intense” abuse, nor do I acknowledge that there is some kind of objective way to measure the intensity of any abuse, I think you’re providing a great argument for the rarity of trans w.r.t. the population at large with that sentence.

    Even repeated rape won’t do it.

    Rape does not shame a child for what they are. Rape damages a child’s ability to grow up sexually by associating shame and feelings of violation with adult behavior before the child has a chance to explore that behavior on their own. Those are two VERY DIFFERENT things.

  121. @Josh
    > the most obvious example is parenting. So no, as long as your “personal choice”

    The world is full or truly horrible parents. Do you have any evidence that transsexual people are somehow worse parents? My opinion is that they are probably on average better, both because they are most likely richer (necessary to afford such an elective surgery) and because they are less likely to be close minded religious bigots — a characteristic that is very damaging to children. (Ask me, I can speak from personal experience.)

    But I don’t know actually have data either way. So that would be IMHO.

  122. BTW, for those of you who are feeling a little uncomfortable with transsexual people, you might want to consider that you have a bit on one in your back pocket. Sophie Wilson, a M2F transsexual is responsible for the design of the ARM instruction set, which is licensed to various processor manufacturers to make those ARM chips in your phone.

    Not bad from someone who according to some commenters here, suffered self damaging shame in her childhood.

  123. @Hedge Mage:

    > It would be a hard thing to (dis)prove at all. However, I’ve seen a great deal of anecdotal evidence to the contrary:

    > * MtF transwomen who were raised in cultures/subcultures where it was *far* better to be male and maleness was celebrated.

    I’m not actually surprised by that, and in fact, I think there’s a good chance that such cultures might actually have a higher incidence of MtF transgenderism than others (see my response to Ken). If a culture has an attitude along the lines of “Mr. Man Leeman is the standard of manly awesomeness. Anyone who is not as manly as Man Leeman may as well be wearing a frilly pink dress and pigtails,” then there may well be a lot of very manly men in that culture that aren’t as manly as Man Leeman (or *think* they aren’t as manly as Man Leeman) who think they’re somehow feminine just because the standard of masculinity is so high.

    This may also have something to do with the whole “breaking barriers” thing. For the people most likely to see a female behaving as a male as a bad thing, the center of the male female scale has been moved a couple miles in the “male” direction so that it’s hardly possible for any female to be seen as behaving like a male.

  124. Ken Burnside: OK. It looked as though you wrote that you were personally acquainted with 60 former SOCOM who were TS. Clarification is good.

    Side issue. My name is RostrOm. That’s my sore toe – the one thing I always complain about. Hrumph.

  125. Hedgemage: It takes *intense* abuse — the likes of which I won’t describe here — to cause kids to have gender-identity issues. Even repeated rape won’t do it.

    Won’t do it every time – or never does it? Causes and effects are not always strict linkages.

    Knowing some incidents of A that didn’t result in B is not evidence of non-causation, even if one doesn’t know any incidents of A that did result in B. That requires a comprehensive knowledge of incidents of A. Which in this case, I hope you don’t have.

  126. If someone insists solving his software problems in hardware, well, let him do so. But I can’t see any reason for society to actively support such nonsense. A child refusing to acknowledge the laws of physics will get an F, have to repeat the course and may finally fail to achieve a grade. But you don’t start to create a fantasy world for the child to live in. And IMHO that’s what society is doing by inventing a mythical concept of a gender identity independent from sex, instead of giving those people an F in biology and sending them back to school.

    Of course that’s not a real solution for the problems. But what *are* the problems? Is it, that men believe they were women or isn’t it more they believe to be what a women is in their imagination? The comment about the fuzziness of their image of being a woman seems to support that. Projection is a well known concept in psychology. Now if people transform their real unsolvable problems into a believe of living in the wrong body and you cater to their wishes, you actively deny them a chance to recognize their true problems and probably have them solved. This also would be violence against those people, Jay, and it might explain the rather small difference in suicide rates.

  127. @Manfred Wassmann

    If no fixes can be had for the software problem, but hardware modifications which address the problem are available, is it really nonsense? Perhaps it’s not ideal, but sometimes life isn’t ideal, and you have to work with what what’s available.

  128. @Jeremy: If no fixes can be had for the software problem, but hardware modifications which address the problem are available, […]

    Do you really think, that is the case? Or isn’t it just a pretext to get around some uncomfortable points in my statement?

  129. Somebody way up there mused: “Is there an overweening social benefit to accommodating (via surgery) this particular aberrant psychology? In other words, is it wise to artificially propagate an evolutionary mutation with little hope of advancing the species?”

    Um. Actually, surgical treatment effectively removes them from the gene pool. If you want to make really sure, treat them early, lest they breed while trying to figure things out. A couple-three generations and if it’s genetic, the incidence drops way down. Not sure I’d bet very much on it.

    In re intelligence, I don’t know from transpeople (Wendy ["Switched-On Bach"] Carlos is the only example that springs to mind and she’s not what I would call dumb) but I noticed early on that most *obviously* gay or lesbian people were also quite bright, though some tried to conceal it, and I eventually decided it was because the stupid ones didn’t make it. This might explain both the anecdotally-reported incidence of clever trannies and the high suicide rate regardless of treatment: the stupid ones don’t survive. It even accounts for the (alleged) SOCOM anomaly.

    Human society has a place for dumb people. It’s got a (sometimes grudging) place for “different” people who have valued skills/abilities. There aren’t any good spots for people who are both different and dumb — and that’s got to be stressful and depressing. Depressed people under stress are at high risk for suicide.

    As for the “Is surgery appropriate?” question, just as soon as I become A) a surgeon, B) financially responsible for someone about to have such surgery and/or C) Empress of the World, I’ll be sure to formulate an opinion. Otherwise, it neither picks my pocket or breaks my leg, so what do I care? Why do we think we should have a precious little snowflake opinion about every goofball thing other people do or might try?

    Chelsea/Bradley Manning? Not my worry. The .mil and Manning can sort that out and I’m pretty sure it’s not going to involve any costly surgery on the taxpayer’s tab; that’s not how military prison works. What’s with the big line to TP his yard and dump garbage on his front step, anyway? Do the various opinionaters think that’s going to punish him more (more than 35 years or 8-with-good-behavior in jail?) or somehow make it all unhappen? And why is he the poster-child for sex-changes all of a sudden? Should we expect criticism of all IT geeks, or of geekery as a valid lifestyle choice in light of Eric Snowden’s actions? (Uh-oh. I have a dog in that fight!)

  130. Hi Eric,

    I found this discussion late, but couldn’t help noticing that Williamson has missed an important step in the process. Williamson’s thinking goes like this:

    1.) Discover that your brain is differently gendered than your body.

    2.) Try to address the situation via a sex change.

    3.) (Skipped by Williamson.)

    4.) 20% become suicidal.

    Williamson theorizes that the problem is created by Step 1, and if he hadn’t skipped Step 3 (and parts of Step 2) I would agree with him. In fact, the real process looks like this:

    1.) Discover that your brain is differently gendered than your body.

    2.) Try to address the situation via a sex change (or various measures, including discussing the issue with friends and family, psychotherapy, cross-dressing, hormone therapy, etc.)

    3.) Endure ENORMOUS AMOUNTS OF SHIT for attempting to deal with the situation, possibly including some or all of the above: being disowned by your family, fired from your job, forced commitment, religious rejection, verbal abuse, assaults, rapes etc., all because of your attempts to deal with the gender issue. This includes the very ugly realization that you belong to a class of people who get disowned, fired, assaulted, etc., all for similar issues, generally without significant consequences to the abusers. (Obviously the violence of family/societal response to trans-sexuality varies widely from person to person, but this is, in fact, the point.)

    4.) 20% become suicidal.

    The significance of Williamson skipping Step 3 should be immediately obvious.

    Unfortunately, sex-change surgery does nothing to make your family un-disown you or your boss un-fire you and it doesn’t magically reverse assaults you’ve suffered. I further suspect that the surveys you and Williamson are looking at don’t differentiate between those trans-sexuals who were heavily abused and those who were not heavily abused. I would suggest that a survey which controlled for this variable would give dramatically different results that what you’re reporting.

  131. Somebody here should take a look at aebrain.blogspot.com

    It is a blog by a guy who thought he was a guy, produced a son on a woman, and then had his hormones go all funny on him. He, uh, I mean she, has produced all sorts of scientific and medical evidence that she was born with the brain of a woman in the body of a man, along with other hormonal intersexual weirdnesses. This was quite a shock to some of her Internet correspondents, as she was quite into the war on terror when she was a he, and helped design sonar suites for some warships. Oh, she goes by Zoe, these days. She seems like a pleasant reasonable person. Y’all should look up her blog. She has some real science on there about sexual weirdness.

  132. Oh, Bradley is no kind of transsexual. From what I’ve read about him, he is just your ordinary theatrical posturing male faggot, always making scenes, and trouble, and being an embarassment to the community of level-headed homosexual gentlemen, of whom somebody…..

  133. @Alex R.: If you have problems with your family etc. it might be more successful getting some help to solve *that* problem instead of projecting your problems into an irrational belief of living in the wrong body. If you solve nothing more than your projected problem, your real problems of course will persist.

    @Justthisguy: A major feature of the human brain is its ability to adapt. While there are hardwired programs in the human brain, these relate to very low level functions – comparably to the BIOS in a PC – and not to complex constructs like being a man or woman. The free programability of the human brain is what made mankind a success. IMHO any “scientific or medical evidence” of the existence of a man’s or woman’s brain is no more scientific than astrology.
    And when it is presented by a man who has undergone medical treatment to remove him from the Paraiyar caste of western societies, which men have become during the latter half of the twentieth century, it obviously is a rationalization (in its psychological sense).

  134. Manfred Wassmann: If YOU have problems with YOUR family etc. it might be more successful getting some help to solve *that* problem instead of projecting YOUR problems into an irrational belief of living in the wrong body.*

    Manfred, I’m a married, heterosexual, white cis-male who has no interest in changing his sex and no close connections with any trans people. It was immediately obvious to me that Williamson had left something out, though I had to think about it for a little while to understand exactly what it was.

    Attempting to discuss suicide among transgendered people without considering the abuse they suffer and the damage that abuse causes is simple idiocy. End of story. I believe you’re capable of typing “transsexual prejudice” into a search engine and interpreting the results without my help.

    Thanks for playing.

    * Capitalization by Alex.

  135. @Alex: Answering you I adapted to the style you chose for your post, so don’t blame me. Then, what I tried to point out was, not only Williamson but you too did forget something. The brain usually does not invent solutions out of the blue, there has to be a problem first. Thus your list has to be augmented by

    0) Have a problem you can’t solve

    and then comes your turn

    1.) [To solve the unsolvable problem your brain invents a projection and lets you] discover that your brain is differently gendered than your body.

    2.) Try to address the situation via a sex change.

    […]

  136. I guess the “transsexual” Bradley Manning will have something to do while in prison BUT I trust he/she has to come up with the cash for his/her treatment.

  137. I’m a 35 year old post-op female who had surgery at 24, and had started hormones at 20. I live what is called stealth, but my experience is more stealth-ish, as a small percentage I can tell knows. I don’t regret who I am and/or became, but my interactions with other people have slowly made me go more and more crazy as I get older. There are three type of men, ones who want to date us and/or sleep with us, ones who hate us, and then ones who just treat you like any other normal human being without an agenda. The part that makes me go crazy is when people who find out will ACT like they’re ok with it, and go overboard on the polite, “it’s ok, it’s ok” attitude, but secretly REALLY think you’re insane and hate you and say what they REALLY feel to those people closest to them. But what they don’t realize is we know that they’re treating us like a disabled person and/or child, and when there’s methods to find out how they really feel makes me all the worse. It’s not the issue of caring too much what people think, it’s the fact they’re SO insanely fake when they have the polar opposite of feelings, and they don’t know that we know. It’s like the equivelant of being really nice to someone and then saying their true opinion of you behind your back but times x1000. And it’s not a paranoid delusion, because people present will see it and comment on it too. Often times it’s society makes us crazy as hell, when I was younger I was so normal and adjusted, but the fact people are so insanely fake about how they feel about trans people and going through to the motions to our face is actually way more damaging if they are straight up rude. Grrr!

  138. @TruthIsInThePudding
    Sartre told us “Hell is the other people”. That is true, as your story shows, but Heaven is the other people too.

    I feel with you. It is little comfort, but the times they are a changing.

  139. @TruthIsInThePudding: Sorry I have to disturb that pretty picture, but please try to imagine how you would react if you realize, a situation you are in is much different from what you expected? Secondly, you can’t have the cake and eat it. You want people to accept your decision to have your gender changed and treat you like anyone else. But when they do while having a different opinion, you call that fake. Huh? You can expect people to ACCEPT your point of view but you cannot require them to BRAINWASH themselves for you, if they have a different one.

    Furthermore, thinking you know what people really think, because someone told you what they told them, really is too naive. You don’t know what they really think, you even don’t know what the people who told you really think they think. It is your interpretation of someone elses interpretation of what they said or even may not have said.

    Finally, thinking people hate you of course saves you from having to question your own point of view. You may feel like a woman and believe it, but there always will be a difference between you and a female born woman, even if it is just the fact they have not undergone a gender transform while you did. And for some people that difference matters, you should accept that just as you want others to accept your point of view.

  140. Misogyny and rape culture, competitive and commercial, creates dissociative personality disorders, and dysmorphia. It is an act of self mutilation. Follow ups would prove failure of current programs and prescriptions.

  141. Misogyny and rape culture, competitive and commercial, creates dissociative personality disorders, and dysmorphia. It is an act of self mutilation. Follow ups would prove failure of current programs and prescriptions.

    I actually can’t tell whether this is satire.

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