Some people describe transgenderism as a mental disorder. They claim that there is a disconnect between a transgender individual's perception of what they are and reality, which is, by definition, a mental disorder. However, I don't think this is necessarily the case.

The words male and female can be used to describe three separate, though correlated, phenomenon: genotypic sex, phenotypic sex, and gender. Genotypic sex is determined by your karyotype, phenotypic sex is determined by your natural body morphology, and gender is socially constructed and determined by how and where you fit into that construct. I know that there are times when genotypic and phenotypic sex don't line up, but for the purpose of this post let's only consider the case in which they do. Therefore, I will simply call it sex and forget the delineation between phenotypic and genotypic sex.

In general, if one is a male in one of those categories he is a male in all of those categories. Because of this, the lines between those categories are not always appreciated and leads to what some have termed cisnormativity. The claim of transgender individuals seems to be that their gender does not align with their sex. Though this flies in the face of normative assumptions, it does not seem to be intrinsically disparate with reality.

One rebuttal I anticipate to this framework is that it does not address the phenomenon of sex reassignment surgery. If one wants to claim that their gender is not cisnormative that's one thing, but why then go through the trouble of altering your body? The answer to this seems to me to be cisnormativity. People identify your gender by what you look like. If you want your gender to be identified as different than what your sex indicates to the rest of the world, how else would you accomplish that? From an outsider's perspective, that's what sex reassignment surgery seems to be addressing.

So transgenderism does not seem to me to be a mental disorder. It simply seems to me to be the recognition that gender and sex are not the same thing.

As a doc, I disagree. There are all kind of dysmorphic personality types labeled in psychiatry. This is no different except it is sexual and political.

dermdoc said:

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As a doc, I disagree. There are all kind of dysmorphic personality types labeled in psychiatry. This is no different except it is sexual and political.

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Is this a scenario of body dysmorphia or not meeting societal expectations?

It might be helpful to evaluate it using the same sorts of criteria that are used to evaluate other syndromes that are classified as "disorders." Note that this is simply the criteria used by current medical and psychological experts and that if you want to argue another set of criteria we can certainly have that conversation. As a general rule, things that do not fit all of these criteria are not considered disorders, for some very obvious reasons. These criteria are also presented in slightly different ways, but generally they are:

Disturbance
Dysfunction
Distress or disability
Deviancy


Disturbance refers to a disruption in normal thought, emotion, or behavior. A classic example of disturbance is the schiophrenic's auditory hallucinations.

Dysfunction refers to behavior, thoughts, or emotions that impair normal living. An example of this is the excessive loss of motivation and fatigue experienced by depressed people that makes it difficult to engage in self-care or even get out of bed.

Deviancy can refer to either (or both) statistical deviancy (i.e. engaging in low frequency behavior) or social norm violations.

Distress or disability refers to what I would call the "suffering" component of the disorder. The changes in thought, emotion, and/or behavior are uncomfortable, unwanted, and the person reacts negatively to them.



So, if we want to analyze transgenderism from this perspective, we get something like the following.

Disturbance. I think you can make a case that feeling or thinking like you are not the sex your biology suggests is a disturbance, though maybe you could make the case that it isn't a clinically significant disturbance.

Dysfunction. Again, you could make somewhat of a case for this being dysfunctional if it impairs your ability to act in the world, which to some degree it does if you tried to act out certain behaviors that don't match your biology.

Deviant. No question that it is deviant in that it doesn't adhere to social norms and is also statistically infrequent.

Distress. This is the one that transgenderism really hinges on in terms of receiving a mental disorder classification. Some people who are transgender are definitely distressed by it, though perhaps not all. This fourth criterion is why transgender was removed and a new category labelled "gender dysphoria" was added in. Those who are experiencing distress receive the gender dysphoria diagnosis, but generally do not receive a diagnosis if they are not distressed.

Body dysmorphia. This stuff has been around forever and was treated appropriately until politics got involved. And Astro, homosexuality is nothing like transgenderism.

And edited to add that body dusmorphic folks want to have surgical alterations a lot of times also. There is nothing new under the sun.

AstroAg17 said:

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I don't understand, I never mentioned homosexuality.

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Sorry I was reading fast.

No, I don't believe so. There's this recent study that, at the very least, should give pause to such claim. I believe as we grow in our understanding of it, we'll see more evidence that it isn't a mental disorder. If there are real structural differences in the brain that match gender identity vs biological sex, then I'm not sure how one could call it mental illness: https://www.telegraph.co.uk/news/2018/05/22/transgender-brain-scans-promised-study-shows-structural-differences/?WT.mc_id=tmg_share_tw

I think it gets labeled such so often because of the suicide rate within the community, but from my understanding, that rate normalizes when in a living, supportive environment. I also haven't seen evidence of higher suicide rates where this, or similar issues, are common and widely accepted in their respective culture (such as the Fa'afafine of American Samoa). On a personal level, and I understand this is merely anecdotal, but I have a very close friend who has spent her life struggling with this. After the depression and suicidal thoughts became overwhelming, she opened up to her about about her struggles. After much prayer and research, her wife suggested trying hormone therapy. She doesn't live fulltime as a woman, but the depression has become virtually non-existent since starting hormones.

All that said, I'm troubled by many who claim it's a mental illness. Not because that belief in and of itself, but because many of these same people say the most horrible, vile things about trans persons. Treatment we'd be rightfully horrified over of the recipient were bipolar, schizophrenic, or any other number of more "common" mental illnesses. It becomes a self-fulfilling prophecy with regards to suicide. Claim it's a mental illness because the suicide rates, while treating them horribly and as pariahs, then point to their subsequent suicide as evidence of their "rightness".

dermdoc said:

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Body dysmorphia. This stuff has been around forever and was treated appropriately until politics got involved. And Astro, homosexuality is nothing like transgenderism.

And edited to add that body dusmorphic folks want to have surgical alterations a lot of times also. There is nothing new under the sun.

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How was it treated appropriately? The treatment of trans individuals is not exactly a shining light in either medicine or society.

You are right to point out the contradiction between a hard-line "gender fluid" position and a simultaneous "trans has a biological basis" position. Gender cannot be both fully arbitrary and biological in origin. The obvious solution is one most reasonable people already adopt: gender is related to biology, but not entirely derived from it. There is some arbitrariness to gender roles and norms, but there is also some non-arbitrariness. How much is due to context and how much is biological in origin is unknown. This is also complicated by the fact that context and biology contribute to gender but also to each other.

Dr. Watson said:

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dermdoc said:

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Body dysmorphia. This stuff has been around forever and was treated appropriately until politics got involved. And Astro, homosexuality is nothing like transgenderism.

And edited to add that body dusmorphic folks want to have surgical alterations a lot of times also. There is nothing new under the sun.

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How was it treated appropriately? The treatment of trans individuals is not exactly a shining light in either medicine or society.

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There are people who identify as lizards, snakes, and aliens. I personally believe trying to treat them with meds makes more sense than doing multiple surgical procedures. The only difference here is the political ramifications.

AstroAg17 said:

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That's not even close to the only difference.

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Okay, explain it to me.

Edited to add that you are born thinking you are something you are not. What is the difference between thinking you are a man when you are a woman or if you think you are a cat and you are a woman? Both are pretty classic dysmorphic psychiatric disorders. One is politically sensitive and one is not. What am I missing?

Two thoughts:
First, the idea that your body is wrong and requires surgical correction is a mental disorder. There are people in the world with two arms and two legs. They are convinced that this is not how their body should be, and they will often go around to surgeons trying to get a healthy limb amputated.

https://nypost.com/2015/09/06/this-strange-condition-makes-people-want-to-hack-off-a-healthy-limb/

No reasonable doctor would consider these people anything except mentally ill. Now imagine that this healthy "limb" that needs to be removed is the male genital organ. This person wants that healthy organ removed and replaced with something that resembles female anatomy. The analogy is a bit oversimplified, but the idea that there is "just something wrong" with a healthy body is definitely pathological.

My second thought is an honest question, and I've never gotten even close to a satisfactory answer for it. Why does a man need to become a woman or vice versa? Our modern society has extremely fluid gender roles. I've seen women drink beer, smoke, gamble at cards, shoot guns, play sports, hunt and other "male" activities. I've seen men wear pink dresses, raise children, keep house, knit and do "female" activities. Biological sex is not a limitation on acceptable behavior in our society. This isn't a Jean d'Arc era where you need be a man to do certain things. There are no strictly defined gender roles. So what's the point of changing gender or biological sex when you can already behave however "masculine" or "feminine" you want regardless of biology?

Bottom line is that if you require surgery to "change" you into something you are not(and there is no health reason needed for the surgery) then it is a psychiatric problem. And I have empathy for those folks. But I have no empathy for docs who do the surgeries. How would you feel about a doc who did heart surgery on you just because you were convinced you had heart disease and you were healthy? And trust me, there are people out there like that too.

dermdoc said:

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Dr. Watson said:

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dermdoc said:

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Body dysmorphia. This stuff has been around forever and was treated appropriately until politics got involved. And Astro, homosexuality is nothing like transgenderism.

And edited to add that body dusmorphic folks want to have surgical alterations a lot of times also. There is nothing new under the sun.

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How was it treated appropriately? The treatment of trans individuals is not exactly a shining light in either medicine or society.

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There are people who identify as lizards, snakes, and aliens. I personally believe trying to treat them with meds makes more sense than doing multiple surgical procedures. The only difference here is the political ramifications.

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The different sexes of humans represent different species? Who knew. We have research showing different grey matter and structure for the sexes and that transgender people's brains fit their perception more than the rest of the physical body. In other words, it isn't some crazy mental condition. They literally have a brain closer to the opposite sex.

dermdoc said:

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Bottom line is that if you require surgery to "change" you into something you are not(and there is no health reason needed for the surgery) then it is a psychiatric problem. And I have empathy for those folks. But I have no empathy for docs who do the surgeries. How would you feel about a doc who did heart surgery on you just because you were convinced you had heart disease and you were healthy? And trust me, there are people out there like that too.

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How much empathy? What should be done with them? Drug them? Institutionalize then? Force them to act differently?

ramblin_ag02 said:

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Two thoughts:
First, the idea that your body is wrong and requires surgical correction is a mental disorder. There are people in the world with two arms and two legs. They are convinced that this is not how their body should be, and they will often go around to surgeons trying to get a healthy limb amputated.

https://nypost.com/2015/09/06/this-strange-condition-makes-people-want-to-hack-off-a-healthy-limb/

No reasonable doctor would consider these people anything except mentally ill. Now imagine that this healthy "limb" that needs to be removed is the male genital organ. This person wants that healthy organ removed and replaced with something that resembles female anatomy. The analogy is a bit oversimplified, but the idea that there is "just something wrong" with a healthy body is definitely pathological.

My second thought is an honest question, and I've never gotten even close to a satisfactory answer for it. Why does a man need to become a woman or vice versa? Our modern society has extremely fluid gender roles. I've seen women drink beer, smoke, gamble at cards, shoot guns, play sports, hunt and other "male" activities. I've seen men wear pink dresses, raise children, keep house, knit and do "female" activities. Biological sex is not a limitation on acceptable behavior in our society. This isn't a Jean d'Arc era where you need be a man to do certain things. There are no strictly defined gender roles. So what's the point of changing gender or biological sex when you can already behave however "masculine" or "feminine" you want regardless of biology?

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Because it isn't an act. It's that they literally feel like strangers in their own bodies.

AstroAg17 said:

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I still don't understand the way "gender" is used. Take this paragraph:

Quote:

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Breakthrough research has revealed for the first time evidence that the brain activity of people who feel they inhabit the wrong body closely resembles that of the gender they want to embrace.

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If gender is a social construct, then how does this make any sense? The word they should use there is sex, because they're talking about physiology. I think transgender people don't really want to be the other gender, they want to pretend to be the other sex. And they may very well have some of the neurological features of the sex they relate to more.

Even the idea that you're in the wrong body is about sex, not gender. I think the term "gender" is used as a way to replace the word "sex" with something that can be changed.

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It's used loosely. Which is the fault of scientists in a lot cases. The idea of sex and gender as the same is popular even if it isn't right. But the term transgender refers to a range of people in various stages while transsexual usually refers to someone who has surgically transitioned.

Dr. Watson said:

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ramblin_ag02 said:

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Two thoughts:
First, the idea that your body is wrong and requires surgical correction is a mental disorder. There are people in the world with two arms and two legs. They are convinced that this is not how their body should be, and they will often go around to surgeons trying to get a healthy limb amputated.

https://nypost.com/2015/09/06/this-strange-condition-makes-people-want-to-hack-off-a-healthy-limb/

No reasonable doctor would consider these people anything except mentally ill. Now imagine that this healthy "limb" that needs to be removed is the male genital organ. This person wants that healthy organ removed and replaced with something that resembles female anatomy. The analogy is a bit oversimplified, but the idea that there is "just something wrong" with a healthy body is definitely pathological.

My second thought is an honest question, and I've never gotten even close to a satisfactory answer for it. Why does a man need to become a woman or vice versa? Our modern society has extremely fluid gender roles. I've seen women drink beer, smoke, gamble at cards, shoot guns, play sports, hunt and other "male" activities. I've seen men wear pink dresses, raise children, keep house, knit and do "female" activities. Biological sex is not a limitation on acceptable behavior in our society. This isn't a Jean d'Arc era where you need be a man to do certain things. There are no strictly defined gender roles. So what's the point of changing gender or biological sex when you can already behave however "masculine" or "feminine" you want regardless of biology?

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Because it isn't an act. It's that they literally feel like strangers in their own bodies.

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And people who want to get a healthy limb cut off are not acting either. They are mentally ill.

Edited to add Let me ask you a question Watson. Do you think folks who want a limb cut off or think they are a cat are mentally ill? Or that docs should do surgery because those folks feel like they are strangers in their own body?

You're making this comparison without anything to back it up besides, "I don't like these things, therefore they are equal." That's not what the research is proving.

Dr. Watson said:

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You're making this comparison without anything to back it up besides, "I don't like these things, therefore they are equal." That's not what the research is proving.

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And that is projection. You are better than that. I have neither a like or dislike except for appropriate medical care. I do not "dislike" people who think they were born the wrong sex, or species, or think they should have a healthy limb cut off. I actually feel a lot of sympathy for these folks, believe it or not.

Dr. Watson said:

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dermdoc said:

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Dr. Watson said:

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dermdoc said:

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Body dysmorphia. This stuff has been around forever and was treated appropriately until politics got involved. And Astro, homosexuality is nothing like transgenderism.

And edited to add that body dusmorphic folks want to have surgical alterations a lot of times also. There is nothing new under the sun.

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How was it treated appropriately? The treatment of trans individuals is not exactly a shining light in either medicine or society.

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There are people who identify as lizards, snakes, and aliens. I personally believe trying to treat them with meds makes more sense than doing multiple surgical procedures. The only difference here is the political ramifications.

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The different sexes of humans represent different species? Who knew. We have research showing different grey matter and structure for the sexes and that transgender people's brains fit their perception more than the rest of the physical body. In other words, it isn't some crazy mental condition. They literally have a brain closer to the opposite sex.

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This is a popular argument but very poorly supported and playing fast and loose with facts.

For starters, it's impossible to have a brain closer to the opposite sex when it's gentically coded XY or XX. And this goes to every organ in the body - male and female kidneys process ambien at different rates, even after transitioning, so a FtM can't get a male dose. There are weak correlations between brain function and cross-gender identification; for instance the sample sizes are small, non-random, and non-representative. The studies about brains fail to distinguish whether these differences occur between populations or individuals. They don't deal with causality or neurotic-plasticity. The brain scan studies are weak and even twin studies contradict the idea of something innate.

One of the arguments put forth that has better merit is that there are two distinct types of MtF transsexuals: homosexual and autogynephilic (hetero males attracted to the image or idea of themselves as a woman).

However the Endocrine Society acknowledged that neither biological or psychological studies provide a satisfactory explanation.

Given that the vast majority of people do not persist in gender dysphoria and come to align with their biological sex, that even the most accepting societies (like Nordic countries) still have suicide rates for transitioners well above the normal human baseline, and extremely high comorbidity rates, it should be continue to be treated as a mental disorder.

Our current scientific consensus spends little time trying to understand the people seeking to transition and digging into their background and more time simply reaffirming what they say when they walk into a psych's office.

RA thinks we'll look antiquated with our treatment but I take the opposite view: I think this will be lumped in with lobotomies in a few decades and remembered as barbaric for pumping small children full of hormones with no human trials or extensive tests to determine the long term affects on the human body. Big pharma sees dollar signs.

Is anorexia a mental disorder?

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Because it isn't an act. It's that they literally feel like strangers in their own bodies.

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I never said it was an act. However, if this has nothing to do with gender roles and is entirely based on "feeling like strangers in their own bodies" then you have quite literally described body dysmorphia. Putting aside the gender role aspect, you're left with an equivalent situation to people that have anorexia, wants limbs removed, want to change races, want to change species, etc.

To me the only difference would be adding gender. In some places in the world a woman literally can't have a job and a man can't be nurturing. So I could see how someone would desire to be the other gender to better fulfill their sense of self. However, that doesn't make any sense in America. Unless someone wants to be a Navy Seal or play professional footbal, there aren't really any strict limitations based on gender or sex.

Blue Star for dermdoc.

100% it's a mental illness and the "treatment" prescribed by the progressives including hormone "therapy" to children is criminal.

AstroAg17 said:

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So what is your definition of gender? Because I don't know what it means if it's not what I posted, and the definition I posted is incompatible with how you're using it.

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Gender traditionally has to do with what activities and behaviors are considered masculine and feminine, hence it is somewhat of a social construct. Think hunting in east Texas as something commonly agreed upon that men do. Someone can be a man and not hunt, but they're not perceived as being as masculine as those that do. It can incorporate sexual behaviors too. Here if two men have sex they're both considered gay. In Brazil only the receiver is because masculinity has to do with fulfilling the male role in sex. There's some biological overlap.

Contemporary liberals are confusing sex and gender which is part of what drives confusion. Sex is binary. Gender is pretty binary (as TGs want to be the other sex; no one transitions to some new gender that's neither male nor female).

Where was the last thread that discussed this?

is it mental illness if you think the supreme being in the universe wants you to cut off part of your genitals? and you do it?