People used to ask this question about gay people (still do, in some corners). Before that, people asked whether blacks were actually capable of intelligent thought or just very good at mimicking white people. Women were at one point believed to widely suffer from an acute mental disorder known as "hysteria".
There are always going to be ugly questions posed under the guise of scientific inquiry about human beings who don't fit into the dominant social group. Because some people in the dominant group will always push for understanding and acceptance, and other people will always seek justification to maintain the status quo. It's herd mentality vs. rationality 101.
A few notes:
1. It's already been pointed out that if we view being transgender as a mental disorder, the same definition would have to apply to homosexuality (or any orientation other than straight). In fact, this definition used to earn homosexuality a place in the DSM (Diagnostic and Statistical Manual of Mental Disorders, the official guidelines for mental health practice in the US). You know when the American Psychiatric Association removed it? 1973. Yeah. Forty-three years ago, people realized that this wasn't a mental illness but essentially an eccentricity of nature.
(Although it wasn't all sunshine and rainbows or an overnight shift in thinking, and there are still definitions in the DSM that are used by extremists to justify psychiatric treatment intended to "cure" LGB individuals, let alone the T.)
An interesting quote from
this article on the subject:
The 'coming out' of homosexuality from the DSM-II allows us to reflect on the following: (1) change in the concept of mental disorder is slow; (2) diagnosis-making is a social act; (3) the construct of illness and disorder, 'mental' or otherwise is a social one; (4) the construct of illness has social consequences; and (5) shifts in the concept and nature of disorder reflect wider social, political and economic forces more than scientific advancement.
Is it a disorder because it strays from what is accepted as a social norm, or is it a disorder because it (without outside influence, and invariably) causes distress to an individual that prevents them from living a fulfilling life? How do we define disorder- by how it affects the individual, or by how it affects those around the individual?
Which leads to the next point:
2. Social stigma against mental disorder or disease can cause as much or more harm than the disorder itself. There is a lot of shame and fear tied up in mental illness. We used to lock up those with mental diseases in asylums where they were abused and left to rot. Even though mental health care has come a long way since then, still many people are failed and often end up homeless or incarcerated.
According to the National Alliance on Mental Illness,
the statistics are sort of horrifying.
Chances are that you, reading this, knows someone with some kind of disorder. Probably something minor, but maybe something more severe. Or maybe you have one yourself. Mental illness is not how it's played up on TV; most mental illness is non-violent and most people with mental health needs are capable of holding down jobs when given proper aid.
There are a lot of myths and misnomers about mental health.
For example, dyslexia is in the DSM and the ICD (basically the international equivalent). Yes, dyslexia is in there while homosexuality is not. It's a disorder (albeit specifically a learning disorder). Dyslexia doesn't harm anyone but the individual who struggles with it. It can't be cured. Instead, kids with dyslexia are given therapy to help them get by and manage their disorder. No one goes around telling dyslexic people "You spelled muffin wrong, haven't you ever looked in the dictionary? Stop spelling things differently just to get attention."
By the by, although "transgender" isn't in the DSM, "gender dysphoria" is. This is not the state of being transgender itself, but the acute discomfort caused by having a different body and/or being forced into a different social role than the one the individual identifies with. So there you have it.
3. On the subject of trans kids being pumped full of hormones and regretting it later because kids don't know what they want... I understand the reservations and fears going on here. But here are some facts:
- There aren't a lot of statistics on regret for sexual reassignment. This is because of how few people actually manage to achieve transition due to the exorbitant costs and social pressures. Many trans adults choose not to transition, or choose only hormones rather than surgery, for various personal reasons. Also most transitions occur in adulthood due to lack of support from family and- until pretty recently- lack of medical expertise in trans youth treatment.
Of course, regret can and will happen. I did find statistics on regret in MtF (male-to-female) sexual reassignment surgery.
According to PubMed, regret may occur in "up to 8%" of cases. Of course this doesn't tell us the reason for the regret. Some of the reasons I've seen actually discussed for regretting hormones/surgery include problems which arise through the limit of surgical science, or due to losing their jobs or social circles over their identity, or other things beyond being mistaken about their gender.
- Hormones are not given to young children because it would fuck up their development. At least in the US, guidelines are for estrogen/testosterone to be started at 16 and surgery after 18. What they sometimes give trans kids at around 12 are called "puberty blockers", which do exactly what they sound like and are intended expressly to address the concerns that kids might not actually know what they want because they're
kids.
There was actually
a study on those blockers not too long ago. Of the 55 trans kids who were diagnosed with gender dysphoria and were given puberty blockers (average age 14), they found that all of them ended up transitioning years later (average age of 21) and that none of them expressed regret about any part of the transition including taking the blockers. They also didn't have any evidence of remaining gender dysphoria.
Of course, that's one study and there's still a lot of necessary research to be done on the subject. However, puberty blockers have been pretty thoroughly tested and are used all the time to treat kids who start puberty too early. They're safe. What hasn't been fully established is the effects it has on kids when they're actually at the right age for puberty, which is what studies like this are trying to establish. Clinical trials and studies are always necessary to prove whether medication is effective; it's an unfortunate risk that the patients involved are always thoroughly informed about.
- Children can stop puberty blockers, go through puberty, and grow up. It's not an irreversible process, if they decide that they are not in fact trans. However, puberty is not reversible. The older an individual is, the less effective HRT may be in altering gender markers.
Also remember that we're talking about teens and preteens, many of whom have known from a young age that they identified differently from their birth sex and are now being pumped full of hormones that give them mood swings and make their developing brains more aware of complex social concepts. Remember that middle and high school are fucking hell, socially speaking, especially for individuals who don't fit in. (Herd mentality again.) Remember that what is listed in the DSM is gender dysphoria and that they have spent most of their life relatively physically similar to all of their peers, but now they and everyone around them are developing gender markers and secondary sexual traits. Remember that teen suicide rates are already high.
If the choice is between seeing your child delay puberty with the chance of yet-undiscovered but potential physical side effects or ending up swallowing a bottle of painkillers, it seems very harsh to judge parents for letting their child have some extra time to think or letting them explore a side of themselves that obviously needs to be explored regardless of which way the final decision goes.
Let's also consider this: Wanting to be Elsa instead of Batman for Halloween might very well just be a phase. Wanting to be called Samantha instead of Samuel for five years running is starting to push it for just being a phase.
4. "The trans people I know are all x"
It might surprise you, but it's actually possible you know someone who is trans and have no clue that they are.
This guy is trans:
So is this lady:
And this former Miss Universe contestant:
Meanwhile, this is a cisgendered woman with hirsutism:
This is a cisgender girl:
And so is this:
This is a cis dude:
And so is this:
So basically, you never know. :U My policy is just go with what the person asks to be called, because I was brought up to be respectful to other human beings. And unless you are dating them, a doctor, or the government, you actually don't need to know that their sex at birth was. Because it doesn't matter.
