Politeness norms seem to keep a lot of folks from discussing or asking their trans friends questions they have, I figured at the very least I could help try to fill the gap. Lemmy has a decent trans population who might be able to provide their perspectives, as well.
Mostly I’m interested in what people are holding back.
The questions I’ve been asked IRL:
- why / how did you pick your name?
- how long have you known?
- how long before you are done transitioning?
- how long do you have to be on HRT?
- is transgender like being transracial?
- what do the surgeries involve?
For the most part, though, I get silence - people don’t want to talk about it, or are afraid to. A lot of times the anxiety is in not knowing how to behave or what would be offensive or not. Some people have been relieved when they learned all they needed to do is see me as my gender, since that became very simple and easy for them.
If there are trans people you know IRL, do you feel you can talk to them about it? Not everyone is as open about it as I am, and questions can be feel rude, so I understand why people would feel hesitant to talk to me, but even when I open the door, people rarely take the opportunity.
The current science points to gender dysphoria being caused by the brain developing as one sex while the body develops as another.
If you ask whether someone is primarily their brain or their body, I think most would say identity resides in the brain and subsequent mind. In that sense, gender dysphoria is a genetic and hormonal disorder, basically a condition of yes, having the “wrong body” for the brain they developed as a fetus. This glosses over a lot of details and sex is complicated, but that’s the rough sketch. The condition arises from the brain and the mind, and in that sense can be labelled a mental illness, but that would ignore a lot of context and evidence we have about what is going on.
It is with this understanding and with the guidance of substantial empirical evidence that transition and gender-affirming care are recommended - it is the only treatment that alleviates symptoms (conversion therapy, for example, increases risk of suicide), but also these are treatments with a very high success to failure ratio. Gender affirming surgeries have lower regret rates than practically any other surgery, much lower than knee replacement surgeries, for example.
So we deal with gender dysphoria differently than we deal with other mental illnesses because of what we know about the condition. We know that people with body dysmorphia like anorexics feel distress about their body and might seek surgery to “fix” their bodies, but we don’t have the large body of evidence that those surgeries improve patient outcomes, relieve symptoms, or are low risk. So we treat anorexia differently than gender dysphoria, because they have different causes and require different treatments.
So gender dysphoria could be classed as a mental illness in a way, but it’s important not to be confused by this and think it’s a fabrication or that people with gender dysphoria could just think their way out of their condition - it’s biological and not able to be solved with therapy or anti-depressants. Trans people respond really well to living as their gender (go figure!), and we see the same with cis people who are raised as the wrong gender (like in the case of David Reimer). We also see that cis people who are forced to take cross-sex hormones, like when homosexuals were given criminal punishments of estrogen treatments in the UK as in the case of Alan Turing, that those people become gender dysphoric in the same way. Gender dysphoria is not just for trans people, forcing cis people to be on the wrong hormones make them depressed too - are cis people just mentally ill when they have symptoms from being forced to live and medically transition to the other sex? It’s not different for trans people.
Took some time and I communicated my question quite poorly and that is on me but I’m gonna try to ask it in a better way.
I feel somewhat strongly that trans-affirming care is the only appropriate approach to treating being trans. I have the impression that as a trans person you feel this is wholly incompatible with my sense that it is a mental health issue. I’d like to explicitly ask why my two beliefs are contradictory.
I’m asking because I am just in the past year or so suffering with severe physical and mental illnesses, and when I try to picture what the trans experience is like, I find that aligns very closely with my mental illnesses and not closely at all with my physical illnesses. I was extremely reluctant to accept that I have a mental illness because of both societal stigma and because in my situation, no one in their right mind would choose to treat my mental illnesses with therapy and pills when a change in living conditions would actually help enormously more, which seemed analogous to treating being trans.
That is what’s made me feel my two beliefs aren’t contradictory, I didn’t understand how deeply I had internalized stigma against the mentally ill until I was asked to apply it to myself. I am imagining that other people would resist identifying as having mental illness in the same way I was. I picture the trans experience as emotional anguish with all physical threats as consequences of that emotional anguish. One where, also like many cases of mental illness, physical treatments are the correct option. But I don’t understand a way to liken it to my experiences with physical illness, so maybe it would be helpful to understand the physical danger and physical suffering explicitly.
I think there are extremely few situations where a mental illness should be treated as something to correct rather than accommodate unless the patient is fully on board with thinking of it as something that needs to be corrected. In many cases, the only reason a patient would be fully on board is societal stigma and designed inaccessibility of accommodations, which is the impression I have of the trans experience as well. That’s the reason I don’t think of options other than trans-affirming care as okay.
I reacted badly because of mental health issues (blehhh) where I obsess over my character and respond to perceived character attacks as an attack on my identity even though I should just be listening. Your response seemed to focus on why I should agree with gender-affirming care and I read that as a character attack, rather than considering that you don’t see it as even possible to believe being trans is a mental health issue that should only be addressed by gender-affirming care. I was being overly wordy to try to be clear that I’m trying to understand how your experience compares with mine, and look we’re back again.
This time I promise I will have the good sense to wait at least a few hours in responding to something that makes me feel bigoted.
What I was getting at with saying I wouldn’t be comfortable switching now, but I would have been fine born into it is there there’s a shock that would come with a change from what you’ve lived, and that being cisgendered wouldn’t negate that shock, it would be miserable, but I don’t feel an attachment in the sense that I feel glad I was born a man. That’s what I meant when saying if I had been born a woman I wouldn’t be happy with the idea of changing to be a man.
This is what I was trying to get at with the difference between suppression and accommodation, and gender-affirming care being accommodation. But I don’t think it’s fair to reduce all mental illnesses to being not biological and being “solved with therapy or anti-depressants”, I think that is part of the stigma against them. Some of them should be accommodated and not suppressed. Physical treatments are often more helpful than those things, different illnesses need to be addressed in different ways, not treated as a generic umbrella for characteristics society doesn’t approve of.
Sorry for not addressing all of it but I’m skeptical that you read what I wrote there because I explicitly spoke in favor of gender-affirming care as the treatment and your response reads to me like I was arguing against it.
David Reimer was forcefully transitioned as a child, when he was young enough to not remember. It created a lifetime of dysphoria for him, and he transitioned back to his birth gender as soon as he understood what had happened to him, and was able to.
It sounds like for you to understand the existence of trans people you probably first need to accept that other people experience gender and sexuality differently than the way you do
Before I do that though, I’m commenting a follow-up to ask you to elaborate on if there’s something specific I can introspect on. I’ll read and think over the next few days.
One last edit:
Logging off is because I know this is an issue I have. Right now I don’t have much to be proud of other than my character, so in a moment I’m bad at listening and taking in criticisms that might suggest bigotry, because it feels like an attack on my identity. I’m aware that in reality I should be listening and not fighting, it just takes me an unreasonable amount of time and I act like a jackass until I’ve processed. Hence, logging out to introspect. Better late than never.
I’ll introspect on that. It generally takes me time to digest. I’m embarrassed here. But I do agree that gender-affirming care is the correct treatment. I read your response like I was not explicit about being in favor of it.
I think I should log off and mull on it because right now I’m just being an asshole. I’m a very slow learner and it generally takes a few days after I argue vehemently against something for it to sink in that I was wrong. I interpreted the first response like you thought I was arguing it should be addressed in a way other than gender-affirming care and responded like that was an attack, which is really shitty of me and pretty embarrassing.