Convince me: gender dysphoria should be treated with gender changes

borrofburi

New Member
The people who are vaguely in my social circles and are willing to speak about the issue of gender dysphoria seem to categorically agree on the broad outlines of how it should be handled:
  • Encourage them to live as their chosen gender
  • Convince society to treat them as their chosen gender (e.g., bathroom laws, pronoun usage, etc.)
  • To the extent that they are comfortable and it is possible, get them surgeries to change their body's sex characteristics

I remain skeptical. I think I have two primary objections and a tertiary objection (more of a rhetorical annoyance).

Primary Objection #1: I'm not convinced that gender dysphoria should be treated on the physical side instead of the mental side. There are a number of body dysphoria disorders and (to my knowledge) we treat all other such disorders by focusing on the mental side of things. If someone has a body dysphoria disorder where their muscles are never big enough for them, then we help them realize that what they see in the mirror is distorted; we don't encourage them to work out more (usually need to cut back), we definitely don't prescribe them steroids, and we certainly don't give them oil to inject so they can make their muscles look extra big. Similarly we don't solve the body dysphoria that causes eating disorders with surgery.

Primary Objection #2: I'm not convinced that gender reassignment surgery works (i.e.,that those who receive have significant benefits commensurate to its costs). I've looked and found nothing close to conclusive; however, I'll admit I'm neither an expert nor sufficiently engaged with the topic that I am perfectly up to date on all such research. Which is to say it's certainly possible I missed some definitive metanalysis.

Tertiary Objection #3: I'm not convinced of this rhetoric that transgendered individuals are categorically horrifically suffering: basically anything mental exists on a spectrum and in the absence of evidence to the contrary we should expect that gender dysphoria lies on a spectrum as well. This means you have individuals at all spots on the scale from extreme comfort to slight comfort to slight discomfort to extreme discomfort.
 

Sparhafoc

Active Member
It's a long and twisty topic that I think is very difficult to do justice to without spending considerably more time chewing through premises on which to build more nuanced points. But I will fire off the cuff and see how far I get.

For me, a fairly significant chunk of what was passing through my mind as I read your post was: who is this notional person?

Is it an abstract person, a this is how we deal with all people with gender dysphoria; or is this a someone I love has gender dysphoria?

I can't help but feel that the first idea might produce more clinical and less sympathetic responses than the latter. I don't know which one I should focus on to respond further, but I can't remove the latter from my mind. For me, a person that I love I want to support, to make them feel happy, to salve any of the pain they experience regardless of whether it's justified to some particular standard of rationality. I don't care if it's irrational; if they're in pain - even if I can't share or empathize with their pain - I certainly don't want to add to that.

Trying to extend that to other people who I don't particularly care about is, for me, a form of moral reasoning. That reasoning may well be imperfect and may also be inconsistent or even produce faintly absurd positions, but we're only human after all.

Personally, I would imagine that encouraging - as in providing compassionate support - for them to live as their chosen gender would be the most appropriate, and if they were ever to have doubts or change their mind, to accept that without any indulgence in hypocrisy. I personally cannot put myself in their shoes, I don't know how they feel, and if they're on a spectrum internally where they may well swing back and forth on their feelings or self-identification, it's not like I need to hold them to what they felt a month or year ago.They can be whoever the hell they want to be - they can be a man during the week, and a woman at the weekends if they so chose, and honestly, I wouldn't have a problem with it... to be honest, I'd probably find it more interesting and refreshing than anything, so long as it was genuine.

Society has to be bullied and berated, dragged into acceptance. That's just history. People en masse tend to be reactionary sorts, stuck in well worn ruts they never bother to peek over. That's fine when it harms no one else, but it cannot be allowed to restrict other peoples' freedom just because they don't conform to those ruts. It's not much to ask to not be a dick, to treat people equitably, to extend rights and justice to everyone. No one's obliged to fall in love with a trans-person or to treat them in ways that any other stranger wouldn't be treated. But prejudice against them is not acceptable any more than prejudice is acceptable against any group. It's fundamental, and any thinking person should agree because if nothing else, it's ultimately self-serving; if X group you don't belong to can be treated badly, then why can't Y group that you do belong to also be treated badly? We extend protection to protect ourselves - to me, that's pretty much a cornerstone of society, of living together as a thinking social animal.

With surgery, I think all it comes down to is support. Are they sure? Are they sure they're sure? Yes, then go ahead - it's no skin off my nose and if it results in them feeling better, then in what way could it be a problem for me? If it's someone I care about, then I am 100% behind them; I'll visit them in hospital, bring cheesy stereotypical gifts appropriate to their new gender to make them groan, and from that day I will refer to them by the gender they've worked to become.

The position I would argue is founded on the harm principle. Is their choice/feeling/nature causing anyone harm? I can't see how. Is my response to their choice/feeling/nature causing harm? Possibly depending on that response. So really I would say the onus of the harm principle would be on how they are treated... and that matters not one jot whether they are right, irrational, confused, or any other emotional or logical state. Live and let live is good. Live and help others thrive is better. I benefit too as a tolerant society is a superior society, in my reasoning.
 

Sparhafoc

Active Member
Oh and as a side point for your own internal discussion that may help resolving convincing yourself either way, look into ContraPoint's Youtube channel: https://www.youtube.com/channel/UCNvsIonJdJ5E4EXMa65VYpA

You need to scan back to her earlier videos to really grasp what's happened. Here we have an amazing person who has gone through their change very publicly online over a period of time, articulating her sense of gender dysphoria in smart, accessible and amusing description.

I love her videos, I think she's an intriguing person, I even find - as a purely heterosexual guy - that I find her attractive... not physically so much as because of her native intelligence, knowledge and articulateness. She seems to reside in her female form more comfortably and more solidly than in the old videos when she was still a man.

She's a very persuasive example of why acceptance can be positive, regardless of whether you find her videos fun or interesting. Whatever the case, she's changed a lot of peoples' mind (for the better), which I personally hold as being an admirable quality.
 

hackenslash

New Member
Interestingly, I've only recently written on this topic. It should address your concerns. Happy to hear about it if not.

https://www.hackenslash.co.uk/2019/11/im-alright-jack-or-jill.html

I should add that much of the suffering comes not only as a result of being in the body that they've been arbitrarily assigned, but on the vilification by society. Dysphoria isn't the only factor, though it certainly plays a part, it's also that being non-binary makes one a target for societal strife.

I know very many transgender and non-binary people, and I do know that they're subject to a fuck of a lot more abuse than most, including the most vile sexual and physical abuse. I address some of that in the linked piece.
 

borrofburi

New Member
I'll have to get to the other posts later.
Sparhafoc said:
For me, a fairly significant chunk of what was passing through my mind as I read your post was: who is this notional person?

Is it an abstract person, a this is how we deal with all people with gender dysphoria; or is this a someone I love has gender dysphoria?

I can't help but feel that the first idea might produce more clinical and less sympathetic responses than the latter. I don't know which one I should focus on to respond further, but I can't remove the latter from my mind. For me, a person that I love I want to support, to make them feel happy, to salve any of the pain they experience regardless of whether it's justified to some particular standard of rationality. I don't care if it's irrational; if they're in pain - even if I can't share or empathize with their pain - I certainly don't want to add to that.

Trying to extend that to other people who I don't particularly care about is, for me, a form of moral reasoning. That reasoning may well be imperfect and may also be inconsistent or even produce faintly absurd positions, but we're only human after all.

Personally, I would imagine that encouraging - as in providing compassionate support - for them to live as their chosen gender would be the most appropriate, ...
It doesn't matter who it is. The optimal treatment doesn't change based on whether you love that person or not. "I care about them personally" does not mean it becomes a good idea to give steroids to a body dysmorphic body builder, nor dieting pills to someone with an eating disorder (caused by body dysmorphia).
Sparhafoc said:
Personally, I would imagine that encouraging - as in providing compassionate support - for them to live as their chosen gender would be the most appropriate, ...
That's exactly one of the assumptions I am unconvinced is true. We don't provide compassionate support to other body dysphoria disorders. That you imagine it's the right thing to do does not make it the right thing to do.
Sparhafoc said:
Personally, I would imagine that encouraging - as in providing compassionate support - for them to live as their chosen gender would be the most appropriate, and if they were ever to have doubts or change their mind, to accept that without any indulgence in hypocrisy. I personally cannot put myself in their shoes, I don't know how they feel, and if they're on a spectrum internally where they may well swing back and forth on their feelings or self-identification, it's not like I need to hold them to what they felt a month or year ago.They can be whoever the hell they want to be - they can be a man during the week, and a woman at the weekends if they so chose, and honestly, I wouldn't have a problem with it... to be honest, I'd probably find it more interesting and refreshing than anything, so long as it was genuine.
I think you misunderstood what I meant by "spectrum" here. When I said spectrum, I meant more along the lines of the autistic spectrum or the Kinsey Scale. The Kinsey Scale is probably the perfect example with not only convenient labels but also because of convenient comparison with pro-gay movement.

There's two reasons early pro-gay rhetoric concerned itself only with the perfect 6s on the Kinsey Scale and ignored the inconvenient 3s: (1) bisexual people complicate the narrative that "they're born this way and suffer greatly" and (2) perfect 6s are more likely to have trouble fitting into an anti-gay society and thus are more likely to be among the early challengers (so the initial stories come from perfect 6s because 3s are underrepresented).

I think there's something similar going on with gender dysphoria where we have this false but convenient narrative that ignores those with minor and moderate gender dysphoria. It wasn't a large point (hence why it was labeled as tertiary), but all mistruths bother me.
Sparhafoc said:
Society has to be bullied and berated, dragged into acceptance. That's just history.
I strongly disagree with the idea that society has be bullied into compliance and I think it's had horrific effects on our ability to have conversations about things. There's something of a knee jerk reaction these days that if someone disagrees with you, even if it's only a minor disagreement, then the thing to do is to bully them, shame them, and ostracize them (for being racist, or misogynist, or trans phobic, or a host of other conversation terminating labels). It's an astoundingly effective strategy: everyone else quickly learns to smile and nod else they'll be next.

But it makes for an environment where truth quickly stops mattering because no where in this process was there any connection to truth.
Sparhafoc said:
It's fundamental, and any thinking person should agree ...
I think this is also dangerous because the contrapositive is that if they disagree then they aren't a thinking person. Labeling them as "not thinking" not only prevents having a discourse with them but also understanding them, and even if they are doomed to be your enemy it's still useful to understand them, their position, and why they believe it.
Sparhafoc said:
With surgery, I think all it comes down to is support. Are they sure? Are they sure they're sure?
And how does this translate to body dysmorphic people who inject oil into their muscles to make their muscles look bigger? Or those who use steroids? Anorexia? Bulimia? Even more extreme forms of body dysmorphia where certain body parts feel wrong? We don't support those people despite their certainty. The typical rationale for this is that they're explicitly not in a state of mind that can be trusted to make those kinds of decisions.
Sparhafoc said:
Yes, then go ahead - it's no skin off my nose and if it results in them feeling better
Whether it results in them "feeling better" is essentially what I am questioning. Though to be explicit: what really matters is medium and long term outcomes (plenty of overall negative things "feel better" in the short term).

I'll have to get to the other posts later.
 

Sparhafoc

Active Member
Following your response, I really only have 1 question.

You say that you are skeptical.

Are you sure?

Your response doesn't look skeptical to me.
 

Sparhafoc

Active Member
Incidentally though, you completely misread this:

It's fundamental, and any thinking person should agree because if nothing else, it's ultimately self-serving;

Any thinking person should agree because it is self-serving to extend societal protection to groups of people else what is the justification for society to extend protection to you?

That is why it is 'any thinking person', not to demean, but to clarify that it is not a position emoted or automatic. Of course, people who don't think may well disagree, but then they're operating under a paradigm in which they're in a dominant group and consequently don't have to be concerned about society turning on them and limiting their freedoms.
First they came for the Communists
And I did not speak out
Because I was not a Communist

Then they came for the Socialists
And I did not speak out
Because I was not a Socialist

Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist

Then they came for the Jews
And I did not speak out
Because I was not a Jew

Then they came for me
And there was no one left
To speak out for me
This is why Communists, Socialists, Trade Unionists and Jews must be protected, not because we have to agree with them or even like them, but because failing to protect them from society means failing to protect yourself from society. The actually dangerous people are those who don't think and who use their unearned position of societal privilege to attack those from subgroups they don't belong to. Again, history provides ample examples of this aspect of human dominant group psychology.
 

he_who_is_nobody

Active Member
borrofburi said:
I strongly disagree with the idea that society has be bullied into compliance and I think it's had horrific effects on our ability to have conversations about things. There's something of a knee jerk reaction these days that if someone disagrees with you, even if it's only a minor disagreement, then the thing to do is to bully them, shame them, and ostracize them (for being racist, or misogynist, or trans phobic, or a host of other conversation terminating labels). It's an astoundingly effective strategy: everyone else quickly learns to smile and nod else they'll be next.
I want to point out that this narrative of people having a knee-jerk reaction being a new occurrence is wrong. Perhaps it is because I grew up in the 90s and was a young contrarian, but people trying to bully, shame, and isolate has always been around. Back then, it was being called a faggot if you supported gay rights. In the 2000s, if you apposed the US interference in the Middle East, you were called unpatriotic and a whole host of things. And it did not start back then either. I mean, there is an entire history of being called a nigger lover for supporting civil rights for Blacks.

Knee-jerk reactions to silence the opposition is not new or unique. We have never had a good relationship with public dialogue in our society.
 

borrofburi

New Member
hackenslash said:
Interestingly, I've only recently written on this topic. It should address your concerns. Happy to hear about it if not.

https://www.hackenslash.co.uk/2019/11/im-alright-jack-or-jill.html

I should add that much of the suffering comes not only as a result of being in the body that they've been arbitrarily assigned, but on the vilification by society. Dysphoria isn't the only factor, though it certainly plays a part, it's also that being non-binary makes one a target for societal strife.

I know very many transgender and non-binary people, and I do know that they're subject to a fuck of a lot more abuse than most, including the most vile sexual and physical abuse. I address some of that in the linked piece.
It very much did not address any of my questions. How, exactly, does your post address the best treatment for gender dysphoria?
Sparhafoc and he_who_is_nobody youtube videos
I'll admit these are a bit low on my priority list for a number of reasons. The first is that I find the information density of audio/video to be rather low, and so the value gained for time spent tends to be mediocre. The second is that audio/video tends to be a horrible format for presenting evidence.

The third is a bit unfair on my part: I suspect I already know this format and it'll be one person's anecdotal journey, but that is not evidence. Plenty of body dysphoric people will argue (quite passionately) that their extreme diet (and exercise) makes them feel better. Some might even be both (self-)honest and correct, but diet is still not a good treatment for that kind of body dysphoria.
 

borrofburi

New Member
Sparhafoc said:
Incidentally though, you completely misread this:

It's fundamental, and any thinking person should agree because if nothing else, it's ultimately self-serving;

Any thinking person should agree because it is self-serving to extend societal protection to groups of people else what is the justification for society to extend protection to you?

That is why it is 'any thinking person', not to demean, but to clarify that it is not a position emoted or automatic. Of course, people who don't think may well disagree, but then they're operating under a paradigm in which they're in a dominant group and consequently don't have to be concerned about society turning on them and limiting their freedoms.
First they came for the Communists
And I did not speak out
Because I was not a Communist

Then they came for the Socialists
And I did not speak out
Because I was not a Socialist

Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist

Then they came for the Jews
And I did not speak out
Because I was not a Jew

Then they came for me
And there was no one left
To speak out for me
This is why Communists, Socialists, Trade Unionists and Jews must be protected, not because we have to agree with them or even like them, but because failing to protect them from society means failing to protect yourself from society. The actually dangerous people are those who don't think and who use their unearned position of societal privilege to attack those from subgroups they don't belong to. Again, history provides ample examples of this aspect of human dominant group psychology.
Rather hyperbolic of you, jumping from treatment for gender dysphoria to Nazi purges.
Sparhafoc said:
Following your response, I really only have 1 question.

You say that you are skeptical.

Are you sure?

Your response doesn't look skeptical to me.
It hardly seems fair that asking for evidence leads to an accusation of certainty. There is plenty of evidence that will change my mind, but you've not really attempted to provide any. Phrases like "I would imagine" are not convincing evidence, and phrases like "if it results in them feeling better" are perfectly emblematic of my very question: does it result in good outcomes?
 

Sparhafoc

Active Member
borrofburi said:
Rather hyperbolic of you, jumping from treatment for gender dysphoria to Nazi purges.
Umm?

I didn't actually talk about Nazi purges at all. I cited a poem which was written about Nazi treatment of groups, but the point therein has nothing expressly to do with Naziism at all. The context is all the rest of the words I wrote.

borrofburi said:
Sparhafoc said:
Following your response, I really only have 1 question.

You say that you are skeptical.

Are you sure?

Your response doesn't look skeptical to me.
It hardly seems fair that asking for evidence leads to an accusation of certainty.
Borrofuri, I would be grateful if you respond to what I write rather than to things I didn't write.

I didn't talk about Nazis or accuse you of being certain.

I said your post above didn't look skeptical, as in, you don't appear to be weighing up two different competing propositions as if they're of equal plausible merit. I made no comment on your degree of certainty at all.

Further, it's not an accusation. I asked you if you're sure you're employing skepticism. I don't know your intent and it's a lot more difficult for me to divine your intent than it is for you to divine your intent, that's why I asked you directly. Are you sure you're skeptical?

borrofburi said:
There is plenty of evidence that will change my mind, but you've not really attempted to provide any.
What evidence are we talking about? Isn't this about the subjective feelings of people with gender dysphoria? If so, why isn't what they say considered 'evidence'? If you go to hospital with pain, that self-reporting of pain is used by doctors as sufficient evidence to warrant investigating a physical cause. Even after an unsuccessful investigation, the continued presence of pain can be considered pathological all by itself: chronic pain.

I unfortunately have had direct experience of this this year. In the last days of last year, I began experiencing absolutely crippling pain in my face. I mean, horrifying levels of pain... absolutely unbearable levels of pain. Over the course of the next 2 weeks, the episodes of pain went from 10 minute periods once a day, to hour long periods 4 or 5 times a day. Each event would then take an hour or so to recover from. I have a pretty high pain tolerance, but within 2 weeks, I was quite literally terrified waiting for the next episode. Medical investigation found nothing - not a single jot of physical evidence that there is anything wrong with me. This in itself is indicative of a diagnosis: neuropathic pain. Something has damaged, or possibly in a worst case is causing the degeneration of the myelin sheath of my tri-geminal nerve. This in turn causes the nerve to spasm, sending signals to the brain which it interprets as FUCK ME OUR FACE IS ON FIRE!! That diagnosis is comprised primarily of my personal, subjective report of pain, and secondarily, the complete lack of physical evidence which would be consistent with nociceptive pain.

So I think you should consider what 'evidence' is meant to mean in this arena, because if you're looking for a piece of physical evidence then you're not going to find it, but that doesn't indicate 'no evidence'. Why isn't self-reporting considered evidence in cases that are about peoples' subjective experiences?

borrofburi said:
Phrases like "I would imagine" are not convincing evidence, and phrases like "if it results in them feeling better" are perfectly emblematic of my very question: does it result in good outcomes?
Honestly, I'll be completely frank with you - I feel like you're intentionally overlooking the parts of my post which already set out why I would find responding to this topic difficult, and you haven't tried at all to engage with me on that level. So I am going to directly ask you to employ a more charitable reading so that we can discuss this in a friendly manner, rather than try to 'beat' each other. I am not trying to 'win' something here, I am trying to give you some nuance to your inquiry that I think is lacking.

So for example, when I write that X matters to me, don't reply that X does not matter as I've just told you that it does for me. If you insist that things which matter to me don't factually matter, then why would I want to continue discussing this with you?
 

Sparhafoc

Active Member
borrofburi said:
The third is a bit unfair on my part: I suspect I already know this format and it'll be one person's anecdotal journey, but that is not evidence.

Can you elaborate on what form this evidence then might take? As in, how would we measure efficacy of a treatment of a subjective feeling of gender dysphoria?

If someone has gender dysphoria, which is defined by the experience of distress due to a mismatch between a person's biological sex and their gender identity - which is naturally entirely based on self-reporting... and they then have gender reassignment surgery, how would we acquire evidence of whether is has successfully alleviated their discomfort or distress in the absence of anecdote?
 

borrofburi

New Member
he_who_is_nobody said:
borrofburi said:
I strongly disagree with the idea that society has be bullied into compliance and I think it's had horrific effects on our ability to have conversations about things. There's something of a knee jerk reaction these days that if someone disagrees with you, even if it's only a minor disagreement, then the thing to do is to bully them, shame them, and ostracize them (for being racist, or misogynist, or trans phobic, or a host of other conversation terminating labels). It's an astoundingly effective strategy: everyone else quickly learns to smile and nod else they'll be next.
I want to point out that this narrative of people having a knee-jerk reaction being a new occurrence is wrong. Perhaps it is because I grew up in the 90s and was a young contrarian, but people trying to bully, shame, and isolate has always been around. Back then, it was being called a faggot if you supported gay rights. In the 2000s, if you apposed the US interference in the Middle East, you were called unpatriotic and a whole host of things. And it did not start back then either. I mean, there is an entire history of being called a nigger lover for supporting civil rights for Blacks.

Knee-jerk reactions to silence the opposition is not new or unique. We have never had a good relationship with public dialogue in our society.
You're not wrong, but I think I expressed myself a bit poorly. (lost my original response, sadly my new response is less concise...)

My major concern isn't that there are knee-jerk reactions, it's that there are forces pushing towards stronger more-immediate knee-jerk reactions.

1. Greater Connectivity
Back then it felt more personal (and small scale) and less like a problem endemic to society as a whole. Now with the internet we can, at the drop of a hat, have hundreds of thousands of people simultaneously target a single person in complete ignorance of context.

2. Narratives
The idea that society needs to be bullied into compliance seems to be growing popular. This tends to be justified with historical narratives that over emphasize the effect of the brash. My original reply was objecting to: "Society has to be bullied and berated, dragged into acceptance. That's just history."

3. Explicit Strategy
I've seen a bit less of this (meaning I don't feel like it's "popular" or that it has entered the collective subconscious yet), but I have definitely heard and seen people argue that knee-jerk shaming is a good and valid strategy, with the goal being to chill-discourse. They didn't use those words, of course; it was instead phrased along the lines of "shutting down" "vile" ideas and "making it clear" that such ideas were "unacceptable" "period" (i.e., ignoring context). The more extreme and explicit versions of these get expressed in places where views are more strictly aligned, but it seems like less extreme versions are starting to filter down to society in general (e.g., as the above mentioned narratives), though it's hard to tell if it's that or if it's really just human nature (amplified by the internet).

I'm going back to bed. Only posted this because I noticed I forgot to submit. I'll have to respond to Sparhafoc at a later date.
 

he_who_is_nobody

Active Member
borrofburi said:
Sparhafoc and he_who_is_nobody youtube videos
I'll admit these are a bit low on my priority list for a number of reasons. The first is that I find the information density of audio/video to be rather low, and so the value gained for time spent tends to be mediocre. The second is that audio/video tends to be a horrible format for presenting evidence.

The third is a bit unfair on my part: I suspect I already know this format and it'll be one person's anecdotal journey, but that is not evidence. Plenty of body dysphoric people will argue (quite passionately) that their extreme diet (and exercise) makes them feel better. Some might even be both (self-)honest and correct, but diet is still not a good treatment for that kind of body dysphoria.
When have you ever known me to post anecdotal evidence?

I will put it this way, I am in graduate school right now, so I do not have much time to waste on this forum. This topic is way outside my wheelhouse, so I thought it would be helpful to at least give a valuable source on this topic. I would have loved to write up a several hour-long researched post, mining Zinnia Jones's references in her video, but I do not have that time.

Honestly, the funniest thing about this is that Zinnia Jones's primary complaint is that she is giving out to much information in her videos.

Besides, if a creationist or anthropogenic climate change denier were here and I linked them to AronRa and Potholer54 videos and they retorted as you did, what would you think of them?
borrofburi said:
My major concern isn't that there are knee-jerk reactions, it's that there are forces pushing towards stronger more-immediate knee-jerk reactions.

1. Greater Connectivity
...

2. Narratives
...

3. Explicit Strategy
...
Again, those last two are not new. The only thing new is the internet, which amplifies our stupidity as a species.
 

Sparhafoc

Active Member
Sparhafoc said:
Society has to be bullied and berated, dragged into acceptance. That's just history. People en masse tend to be reactionary sorts, stuck in well worn ruts they never bother to peek over. That's fine when it harms no one else, but it cannot be allowed to restrict other peoples' freedom just because they don't conform to those ruts. It's not much to ask to not be a dick, to treat people equitably, to extend rights and justice to everyone.













 

Leafsdude

New Member
borrofburi said:
Primary Objection #1: I'm not convinced that gender dysphoria should be treated on the physical side instead of the mental side. There are a number of body dysphoria disorders and (to my knowledge) we treat all other such disorders by focusing on the mental side of things. If someone has a body dysphoria disorder where their muscles are never big enough for them, then we help them realize that what they see in the mirror is distorted; we don't encourage them to work out more (usually need to cut back), we definitely don't prescribe them steroids, and we certainly don't give them oil to inject so they can make their muscles look extra big. Similarly we don't solve the body dysphoria that causes eating disorders with surgery.
There's a problem here in your argument in that there's much more significant risks in, say, steroids and muscle growth, versus gender reassignment surgery (GRS). Plus, as you say yourself here, in those cases, increasing whatever it is that they are dysphoric (or whatever that form of the word would/should be) about does not alieviate the problem, because the issues in those cases are that they'll never think they'll be sufficient.

GRS works precisely because it does change their mental outlook fundamentally, from being male to female, or female to male. Unlike the "more muscle mass" issue with body dysphoria that you reference, this is a change that does address the root cause of their gender dysphoria: that they feel they're in the body of someone of the wrong gender.

I think it's also worth pointing out that GRS is, generally, a last resort, and not the first choice offered, and that a lot of people with gender dysphoria do get significant improvement in quality of life with treatment options (for example, hormone replacement therapy) that are less drastic or dangerous than GRS. So your initial need for convincing that dysphoria "should" be treated with GRS is something not even the medical or transgender community agrees with.
 

Dragan Glas

Active Member
Greetings,

A recent paper discusses what the authors explain as "3G sex" - genetic-gonadal-genitals sex - and how this relates to gender. In short, whatever the body's categorization (male, female or intersex), all brains are intersex.

Both Ramachandran, in The Tell-Tale Brain - I found a free pdf - and Seung, in Connectome, show that such issues lie firmly in the neurology of the brain, rather than merely being psychological.

Seung, in particular, is of the opinion that all neurological and/or psychiatric problems will - in the future - be cured through correcting the connectome, how the nerve cells are connected in the brain.

It's worth reproducing the part of Ramachandran's chapter [pages 206-207] where he quickly addresses this issue in discussing how the self is an illusion:
TRANSSEXUALITY: DOCTOR, I‘M TRAPPED IN THE WRONG KIND OF BODY!

The self also has a sex: You think of yourself as male or female and expect others to treat you as such. It is such an ingrained aspect of your self-identity that you hardly ever pause to think about it—until things go awry, at least by the standardsof a conservative, conformist society. The result is the ―disorder‖ called transsexuality.

As with somatoparaphrenia, distortions or mismatches in the SPL can also explain the symptoms of transsexuals. Many male-to-female transsexuals report feeling that their penis seems to be redundant or, again, overpresent and intrusive. Many female-to-male transsexuals report feeling like a man in a woman‘s body, and a majority of them have had a phantom penis since early childhood. Many of these women also report having phantom erections.8In both kinds of transsexuals the discrepancy between internally specified sexual body image—which, surprisingly, includes details of sexual anatomy—and external anatomy leads to an intense discomfort and, again, a yearning to reduce the mismatch.

Scientists have shown that during fetal development, different aspects of sexuality are set in motion in parallel: sexual morphology (external anatomy), sexual identity (what you see yourself as), sexual orientation (what sex you are attracted to), and sexual body image (your brain‘s internal representation of your body parts). Normally these harmonize during physical and social development to culminate in normal sexuality, but they can become uncoupled, leading to deviations that shift the individual toward one or the other end of the spectrum of normal distribution.

I am using the words "normal" and "deviation" here only in the statistical sense relative to the overall human population. I do not mean to imply that these ways of being are undesirable or perverse. Many transsexuals have told me that they would rather have surgery than be ―cured‖ of their desire. If this seems strange, think of intense but unrequited romantic love. Would you request that your desire be removed? There is no simple answer.
Although, at present, gender-reassignment surgery may be a pragmatic solution, in the future - when neuroscientists, and neurologists, can "fix" the connectome at an early age - gender-reassignment surgery may be seen as barbaric as sterilization of the mentally-subnormal.

Kindest regards,

James
 
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