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My Turn To Come Out

January 7, 2015

My Migraine Family

The news of Leelah Alcorn’s suicide has, of course, hit my family hard. And while I wrote a post, erm, a year and a half ago, about being a person of deep faith – in which I only mentioned the name of my religious persuasion in the tags – , this is not something I discuss publicly.

In large part, I do not discuss this publicly because I have had an internal struggle in which I was not sure my transgender child had a place in my faith. And if she did not have a place, that meant it no longer had a place for me. And that was an intensely painful struggle for me.

I am a Bahá’í. And while you may go ahead and google it, you will find little information of value on the internet concerning transgender folk. And frankly, this post is directed at those…

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4 comments

  1. I recently read an article in June in The Wall Street Journal by Dr. Paul R. McHugh, the former psychiatrist-in-chief for Johns Hopkins Hospital and its current Distinguished Service Professor of Psychiatry. Johns Hopkins is world famous.

    His view is that transgenderism is a mental disorder that merits treatment, that sex change is biologically impossible, and that people who promote sexual reassignment surgery are collaborating with and promoting a mental disorder. Dr.McHugh stated that the transgendered person’s disorder is in the person’s assumption that they are different than the physical reality of their body, their maleness or femaleness, as assigned by nature.

    It is a disorder similar to a dangerously thin person suffering anorexia nervosa who looks in the mirror and thinks they are “overweight”. This is clearly a disorder in which the person also has the assumption that they are different from the physical reality of their body. The comparison made sense to me because anorexics are absolutely convinced they are fat and overweight even though they look emaciated like famine victims.

    According to McHugh, transgender advocates do not seem to care that studies show between 70% and 80% of children who express transgender feelings spontaneously lose those feelings over time. Also, for those who had sexual reassignment surgery, most said they were “satisfied” with the operation but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. He states that Johns Hopkins has stopped doing sex-reassignment surgery, since producing a ‘satisfied’ but still troubled patient seemed an inadequate reason for surgically amputating normal organs.

    While Hollywood and major media promote transgenderism as normal Dr. McHugh, argues that policy makers and the media are doing no favors either to the public or the transgendered by treating their confusions as a right in need of defending rather than as a mental disorder that deserves understanding, treatment and prevention. This intensely felt sense of being transgendered constitutes a mental disorder in two respects. The first is that the idea of sex misalignment is simply mistaken – it does not correspond with physical reality. The second is that it can lead to grim psychological outcomes. If science and religion are to be in harmony we need to carefully weigh all points of view and not assume that transgenderism is not a mental disorder. It is better to encourage such people to see trained mental health specialists who can determine the best approach rather than rushing into surgery which may not be the solution.

    This is the link to Dr.McHugh’s artricle: http://www.wsj.com/articles/paul-mchugh-transgender-surgery-isnt-the-solution-1402615120


  2. Hello, I am copying and pasting Dr.McHugh’s article for your perusal because I just remembered the link may not show the complete article which may be gated since the WSJ requires a subscription. You can delete it after reading it without having to post it on your blog.

    Transgender Surgery Isn’t the Solution
    A drastic physical change doesn’t address underlying psycho-social troubles.
    By
    Paul McHugh
    June 12, 2014 7:19 p.m. ET
    The government and media alliance advancing the transgender cause has gone into overdrive in recent weeks. On May 30, a U.S. Department of Health and Human Services review board ruled that Medicare can pay for the “reassignment” surgery sought by the transgendered—those who say that they don’t identify with their biological sex. Earlier last month Defense Secretary Chuck Hagel said that he was “open” to lifting a ban on transgender individuals serving in the military. Time magazine, seeing the trend, ran a cover story for its June 9 issue called “The Transgender Tipping Point: America’s next civil rights frontier.”

    Yet policy makers and the media are doing no favors either to the public or the transgendered by treating their confusions as a right in need of defending rather than as a mental disorder that deserves understanding, treatment and prevention. This intensely felt sense of being transgendered constitutes a mental disorder in two respects. The first is that the idea of sex misalignment is simply mistaken—it does not correspond with physical reality. The second is that it can lead to grim psychological outcomes.

    The transgendered suffer a disorder of “assumption” like those in other disorders familiar to psychiatrists. With the transgendered, the disordered assumption is that the individual differs from what seems given in nature—namely one’s maleness or femaleness. Other kinds of disordered assumptions are held by those who suffer from anorexia and bulimia nervosa, where the assumption that departs from physical reality is the belief by the dangerously thin that they are overweight.

    With body dysmorphic disorder, an often socially crippling condition, the individual is consumed by the assumption “I’m ugly.” These disorders occur in subjects who have come to believe that some of their psycho-social conflicts or problems will be resolved if they can change the way that they appear to others. Such ideas work like ruling passions in their subjects’ minds and tend to be accompanied by a solipsistic argument.

    For the transgendered, this argument holds that one’s feeling of “gender” is a conscious, subjective sense that, being in one’s mind, cannot be questioned by others. The individual often seeks not just society’s tolerance of this “personal truth” but affirmation of it. Here rests the support for “transgender equality,” the demands for government payment for medical and surgical treatments, and for access to all sex-based public roles and privileges.

    With this argument, advocates for the transgendered have persuaded several states—including California, New Jersey and Massachusetts—to pass laws barring psychiatrists, even with parental permission, from striving to restore natural gender feelings to a transgender minor. That government can intrude into parents’ rights to seek help in guiding their children indicates how powerful these advocates have become.

    How to respond? Psychiatrists obviously must challenge the solipsistic concept that what is in the mind cannot be questioned. Disorders of consciousness, after all, represent psychiatry’s domain; declaring them off-limits would eliminate the field. Many will recall how, in the 1990s, an accusation of parental sex abuse of children was deemed unquestionable by the solipsists of the “recovered memory” craze.

    You won’t hear it from those championing transgender equality, but controlled and follow-up studies reveal fundamental problems with this movement. When children who reported transgender feelings were tracked without medical or surgical treatment at both Vanderbilt University and London’s Portman Clinic, 70%-80% of them spontaneously lost those feelings. Some 25% did have persisting feelings; what differentiates those individuals remains to be discerned.

    We at Johns Hopkins University—which in the 1960s was the first American medical center to venture into “sex-reassignment surgery”—launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as “satisfied” by the results, but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. And so at Hopkins we stopped doing sex-reassignment surgery, since producing a “satisfied” but still troubled patient seemed an inadequate reason for surgically amputating normal organs.

    It now appears that our long-ago decision was a wise one. A 2011 study at the Karolinska Institute in Sweden produced the most illuminating results yet regarding the transgendered, evidence that should give advocates pause. The long-term study—up to 30 years—followed 324 people who had sex-reassignment surgery. The study revealed that beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population. This disturbing result has as yet no explanation but probably reflects the growing sense of isolation reported by the aging transgendered after surgery. The high suicide rate certainly challenges the surgery prescription.

    There are subgroups of the transgendered, and for none does “reassignment” seem apt. One group includes male prisoners like Pvt. Bradley Manning, the convicted national-security leaker who now wishes to be called Chelsea. Facing long sentences and the rigors of a men’s prison, they have an obvious motive for wanting to change their sex and hence their prison. Given that they committed their crimes as males, they should be punished as such; after serving their time, they will be free to reconsider their gender.

    Another subgroup consists of young men and women susceptible to suggestion from “everything is normal” sex education, amplified by Internet chat groups. These are the transgender subjects most like anorexia nervosa patients: They become persuaded that seeking a drastic physical change will banish their psycho-social problems. “Diversity” counselors in their schools, rather like cult leaders, may encourage these young people to distance themselves from their families and offer advice on rebutting arguments against having transgender surgery. Treatments here must begin with removing the young person from the suggestive environment and offering a counter-message in family therapy.

    Then there is the subgroup of very young, often prepubescent children who notice distinct sex roles in the culture and, exploring how they fit in, begin imitating the opposite sex. Misguided doctors at medical centers including Boston’s Children’s Hospital have begun trying to treat this behavior by administering puberty-delaying hormones to render later sex-change surgeries less onerous—even though the drugs stunt the children’s growth and risk causing sterility. Given that close to 80% of such children would abandon their confusion and grow naturally into adult life if untreated, these medical interventions come close to child abuse. A better way to help these children: with devoted parenting.

    At the heart of the problem is confusion over the nature of the transgendered. “Sex change” is biologically impossible. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.

    Dr. McHugh, former psychiatrist in chief at Johns Hopkins Hospital, is the author of “Try to Remember: Psychiatry’s Clash Over Meaning, Memory, and Mind” (Dana Press, 2008).


  3. Homa, thanks for sharing the article which I will leave here so anyone can read it. I ask you what is wrong in your view with someone being transgender? I ask rather than finding other papers which would show that views such as “transgenderism is a mental disorder” as not scientifically based because however one defines what is ‘biologically male or female’ is not the issue. It issue is about identity and how one operates in society. The issue is in labelling transgender an illness. So my question is – what harm is there in welcoming individuals who are transgender as equals?

    I end with a link TED talk poem by poet Lee Mokobe.

    “I was the mystery of an anatomy, a question asked but not answered,” says poet Lee Mokobe, a TED Fellow, in this gripping and poetic exploration of identity and transition. It’s a thoughtful reflection on bodies, and the meanings poured into them.


  4. I prefer not to state what is wrong in my view with someone being transgender and prefer to leave it to specialist psychiatrists such as Dr. McHugh to delineate the harmful effects identified not only by Johns Hopkins University and its hospital but in other research he cited in his article. I know there are differing opinions such as those you stated you could cite. There are many more articles re the harm that I could have posted as well.

    For example, this one by Walt Heyer, a former transgender woman, who suffered harmful effects such as those identified by Dr.McHugh: “Changing genders is short-term gain with long-term pain. Its consequences include early mortality, regret, mental illness, and suicide.” http://www.thepublicdiscourse.com/2015/04/14688/
    Of course, my caveat here is that this is anecdotal and only one experience so not from a peer reviewed study of more than 300 transgendered such as the long-term 30 year study by the Karolinska Institute in Sweden referenced by Dr McHugh.

    The only reason I’ve posted McHugh’s article is in the hope that before rushing into irreversible surgery and hormonal gender change for children, adolescents, et al people will give more careful thought to the pros and cons and ensure that underlying psychological problems are addressed. As McHugh notes: “Most of the surgically treated patients described themselves as “satisfied” by the results, but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. And so at Hopkins we stopped doing sex-reassignment surgery, since producing a “satisfied” but still troubled patient seemed an inadequate reason for surgically amputating normal organs.”



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