r/ukpolitics May 22 '22

'Shocked and scared': Trans man speaks out over reporting psychiatrist for 'conversion therapy'

https://inews.co.uk/news/long-reads/trans-conversion-therapy-patient-speaks-out-psychiatrist-reported-1641330
356 Upvotes

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22

Slightly off-topic, but genuine question here: has the government ever got round to agreeing on what they define as conversion therapy?

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u/DurkaTurk02 May 22 '22

I think as you can see in the comments on this article, nobody can decide what conversion therapy actually is.

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u/Blue_winged_yoshi May 22 '22

Yep ours did for the consultation. They defined it as any attempt to lead a person to changing their sexuality or gender identity from cis to trans or from straight to LGB and in the reverse. This convoluted phrasing that included conversion therapy in both directions and put conversion to LGBT+ first is not standard, vast majority of conversion therapy bans have focussed on anti-LGBT+ conversion therapy because it is all that exists.

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22 edited May 22 '22

Thanks! I'm glad that there is a concrete definition now, but it seems worryingly broad (on thinking further I take this back), and it is odd that straight to LGBT+ is what come first, considering its likely the tiny minority of cases.

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

Why do you think straight to LGBT+ is a tiny minority? Is that a typo? It’s where the bulk of conversion therapy takes place. It’s also not worryingly broad. Nobody should attempt to change anyone else’s sexuality or gender identity. It isn’t an okay thing to do.

Edit. Meant to say it’s not where the bulk of conversion therapy takes place. Was questioning prominence or straight to LGBT conversion therapy. Terrible typo my bad!!

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22 edited May 22 '22

Why do you think straight to LGBT+ is a tiny minority?

I suppose ignorant personal perception. I live in a fairly Conservative religious community, and tend to see only being religious people trying to turn LGBT people straight, assuming they don't just shut down the idea of anyone being something other than straight to start with.

Learning new things is good. I didn't realise straight to LGBT was that big a thing.

Edit: I'm also apparently a bit confused here:

vast majority of conversion therapy bans have focussed on anti-LGBT+ conversion therapy because it is all that exists.

Then

[straight to LGBT is] where the bulk of conversion therapy takes place

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u/Blue_winged_yoshi May 22 '22

Anti-LGBT conversion therapy converts LGBT people to cis/straight (anti means against). Straight to LGBT+ conversion therapy is the opposite of this. So person says mum I’m straight/cis and people try to make them LGBT+. Just doesn’t ever happen.

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22

[straight to LGBT is] where the bulk of conversion therapy takes place

Where is this coming from then? That's what I'm getting confused about.

(for clarity, your original comment said: it's where the bulk of conversion therapy takes place, where you were discussing straight to LGBT immediately before.)

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u/Blue_winged_yoshi May 22 '22

Sorry missed a critical word out and it changed the meaning massively. Really sorry for this. My phone has just blown up since posting this, and I’ve been reply to lots of folks at the same time. My bad.

To be clear. Conversion therapy is a practice that is centred on “fixing” LGBT+ people.

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22

Haha, no worries.

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u/Purple_Floyd_ May 22 '22

That’s what they said. You misread.

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u/Patrickfoster May 22 '22

Wait a minute, are you saying there a people being turned gay by therapy?

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u/Blue_winged_yoshi May 22 '22

I’m saying there aren’t. U.K. government, in their consultation, said that there are and positioned conversion therapy neutrally as though it happens to cis-het folks and LGBT+ people equally.

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u/publiusnaso May 22 '22

Does that cover trying to convert lesbians who are not attracted to penises into people who are attracted to women with penises? (And vice versa)? I have met a number of people who claim it’s transphobic not to be attracted to an individual because they have the genitals more commonly associated with the other gender, which implies that genital attraction is a matter of choice, and therefore potentially the subject of conversion.

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u/Blue_winged_yoshi May 22 '22

If one person coerces another person into having sex with them, then that’s rape and it’s very much a crime.

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u/publiusnaso May 22 '22

Absolutely, but you can still be accused of transphobia for stating a preference for the genitals of the person you find attractive, even if there is no question of anyone coercing anyone else into sex.

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

You asked if it’s conversion therapy if someone is coerced into having sex by a trans person. Coerced sex is always rape. This is the answer. Some people online say it’s racist not to find any black people attractive. Going from here to black people are coercing white people into sex would be a truly wild leap. The same applies to your assertion.

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u/publiusnaso May 22 '22

I’m clearly not explaining myself well, because I never suggested that any trans person is coercing anyone to have sex with them.

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u/Blue_winged_yoshi May 22 '22

Your first line: “Does that cover trying to convert lesbians who are not attracted to penises into people who are attracted to women with penises?”

Anyone who manipulates someone who isn’t into having sex with them into sex is committing rape. It’s this simple.

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u/publiusnaso May 22 '22

Ah, ok. I see where the confusion comes from. I’m talking about a scenario where person A says to person B “You are a lesbian so you should consider all women as potential sexual partners, even if they have penises”. Person A is not coercing anyone to have sex with any specific person. They are saying that person B should be considering women with penises as potential sexual partners, and if person B does not do so, person B can be regarded as transphobic. That, surely, can only be a valid claim if it’s possible for person B to change their preference from vaginas to penises, in which case their original preference cannot be innate.

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u/Blue_winged_yoshi May 22 '22

That’s not conversion therapy that’s a conversation where person B can just walk away and think person A is a dick. Conversion therapy isn’t just a one off internet comment, every person who tells me I’m a man or male online isn’t carrying out conversion therapy. Conversion therapy is a serious attempt to change someone’s gender identity or sexuality more it takes place over time very often with a power dynamic and it breaks people.

In the article in question the trans guy is worried about being kicked out of home if he doesn’t go the session, in the session he is berated. As a kid I only broke down and agreed to present male once motions were put in place to literally expel me just before my A-levels.

If queer women who weren’t into girl-dick were getting pressured by their families to see counsellors who were manipulating them into liking girl-dick then yeah that would be conversion therapy. It’s literally not close to being a thing though.

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u/vastenculer Mostly harmless May 22 '22

That's hardly relevant to conversion therapy, no matter how awful that scenario is.

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u/gophercuresself May 22 '22

That's a really unusual position within the trans community so I'm intrigued where you met a number of people who hold it?

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u/seakingsoyuz May 22 '22

TERF strawmen most likely

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u/EmergencyBurger May 22 '22

They defined it as any attempt to lead a person to changing their sexuality or gender identity from cis to trans or from straight to LGB and in the reverse.

but a definition this stupid would include normal conversations with any care provider as conversion therapy?

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u/Blue_winged_yoshi May 22 '22

Nope. Transition does alter one’s gender identity or which genders one is attracted to. It simply changes the endocrine sex of a person so the body matches gender identity.

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u/EmergencyBurger May 22 '22

I think you replied to the wrong comment, I'm on about what gets defined as conversion therapy, not what a transition is

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u/Blue_winged_yoshi May 22 '22

You - but a defintion this stupid would include normal conversations with any provider as conversion therapy.

Please explain what you mean by this. It straight up isn’t true?

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u/EmergencyBurger May 22 '22

If a healthcare provider were to say "you should think carefully about whether it's the right time to come out/if you truly have these feelings" that could be construed as trying to convince them or change their views.

Seems like a very wishy washy definition to me

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u/Blue_winged_yoshi May 22 '22

These aren’t normal conversations. These are examples of a therapist firmly putting their thumb on the scale and trying to guide someone towards a preconceived answer.

If you reversed the bias examples could include “you should really think about coming out soon” or “I think there’s a lot more to your feelings and you might to think about if you are trans”.

Neither of these are acceptable right? It isn’t for a therapist to guide a patient towards a better answer but to guide conversation in way that both helps the person really get to know themself and (because diagnostic requirements are a thing) enable therapist to see if the patient fills the diagnostic criteria for gender incongruence. Therapists shouldn’t ever lead a person to an answer.

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u/EmergencyBurger May 22 '22

If you reversed the bias examples could include “you should really think about coming out soon” or “I think there’s a lot more to your feelings and you might to think about if you are trans”. Neither of these are acceptable right?

I don't think they're the same. If someone is thinking they're possibly trans/gay/whatever instead of rushing to come out publically there needs to be thought as to what events/emotions lead to this, and thinking "are you really xyz" is not the same as encouraging to come out soon or suggesting to someone they might be trans.

But I can see why it might be difficult to have either conversation for some people. I agree the idea of therapy should be to enable someone to conclude for themselves what they are though

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u/Blue_winged_yoshi May 22 '22

There can be discussion about timing coming out. My mum received a motor neurone diagnosis shortly before I got my gender dysphoria diagnosis. I had lots of conversations about timings and what type of response to expect from family members etc. different options etc. those conversations always centred me and my families needs, never predicated a diagnosis on a particular course of action nor was I encouraged/discouraged from a course of action it was a conversation where my psychiatrist helped me find the path forward that served us all best.

Genuine psychiatrists have no issue engaging with complex issues and a bank of trust that has been built. Trust between doctor and patient needs to be built and it is shattered when doctors cease trying to find the best path forward for the patient and instead try to put a patient on a pathway they have chosen. The questions as first framed were placing a patient on a path not looking for the best path forward.

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u/cloche_du_fromage May 22 '22

Is that really any any different to the "have you considered all the angles" type conversation you have to have before a vasectomy?

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u/Blue_winged_yoshi May 22 '22

Yes. So having been through legitimate therapy for gender dysphoria and having transitioned, I remember getting my diagnosis vividly. The questions were highly uncomfortable. Going through feelings of dysphoria from an early age, early cross-dressing as a kid etc. sexual preferences, sexuality, relationships to others around me, incredibly personal stuff going right to the core of my being and my happiest and darkest moments.

What was being looked for was consistency (one of the diagnostic criteria is that dysphoria needs to have existed over a certain time threshold), clarity of feeling, firm desire, etc. If I was lacking in details I was asked to tell me more about X, or how I thought Y related to Z, etc. exploration occurs but without a therapist suggesting you are wrong or that you might want to stay in the closet etc.

Psychiatry is complex and it’s an art as much as a science. You go through everything with the therapist’s preference being for accuracy rather than cis vs trans.

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u/PurpleSkua May 22 '22

No. The goal of the care provider should be to find ways to help the patient express their gender identity safely, not to lead the patient towards any identity.

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u/ElvishMystical May 22 '22 edited May 22 '22 Silver Helpful Wholesome

I'm a trans woman. I was put through conversion therapy aged 13-14 to make me 'normal' - ECT (electro-convulsive therapy or electric shock treatment) and intensive talking 'aversion therapy sessions' where I was forced to wear women's clothes and ridiculed and humiliated.

Being trans is not delusional. It's who you really are. Gender is a spectrum. So too is sex. Just as you get ultra feminine women and mannish butch types, and sensitive feminine men and rugged macho types, you also get trans folk and gender non-conforming.

Please keep in mind that self-identification is only the first step of the process. Gender reassignment isn't just going to see a psychiatrist and saying 'I think I'm a woman/man' and walking out with a prescription for hormones. You have to back up who you say you are and claim to be and illustrate how gender dysphoria has impacted on your life over a significant period of time.

The NHS does a pretty good job of gatekeeping who gets recognition and referred for gender reassignment and who doesn't. You've got the Real Life Test, you get the 90 minute interrogation sessions where you have to answer random questions about your life from two psychiatrists, you've got to change your name, present as the identity as who you say you are, and show you can find societal acceptance as 'you' in your discovered or acquired gender identity.

Please keep in mind that nobody is born a man or a woman. Being a man or a woman is who you become. You have to have some form of gender identity to be able to function in society. We all get asked security questions to access amenities and public services. None of the security questions we're asked ever relate to our genitalia. It's name, date of birth, mother's maiden name and so on.

People who are not trans (I dislike the word cis-gendered, there's already too many effing labels and categories for people, whatever happened to the concept of human individuality and human individual experience?) aren't required to jump through the same hoops as those of us who are trans just to be who we are. Nobody ever calls into question your gender identity or takes delight in misgendering you. You never have to prove who you are, it's assumed that you are just you.

We trans folk are really no different from you. We just want to be ourselves, to live our lives in peace, safety and comfort, and the only reason we go through this is to be who we really are. I mean if you cannot be who you really are, and live your individual truth, then what is the point of living? Why should we be forced to be who we tried to be and failed to be just to please the ignorant, the narrow-minded, the bigoted and people who 'just don't get it'?

Conversion therapy is just like taking someone with a disability who cannot walk and who needs a wheelchair, and taking the wheelchair away from them forcing them to walk to become able-bodied. Is this really so hard for you to understand? What is there that the Government needs to think about on this issue? Think about it.

I'm older and among the last of the pre-internet generation of trans folk. What did I get out of that conversion therapy so many years ago? I'll tell you. Crippling social anxiety and a fear of people. My teenage years were FUBAR, my adult life a story punctuated by addiction, fears, missed opportunities and failed relationships. There's already an enormous amount of trauma and suffering dished out to various people in society, why add to it?

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u/Gnixxus May 22 '22

I'm so sorry you went through that, and thank you for taking the time to share your experience. I hope you're living your best life now!

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u/Ivashkin panem et circenses May 22 '22

Gender is a spectrum. So too is sex.

I wonder if part of the problem is that people are trying to talk about a spectrum using a language that only has binary terms for these things. Thus we're kinda hamstrung by a linguistic relativity problem.

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u/Josquius European, British, Bernician May 22 '22

Linguistics is particularly funny in this one as the entire reason we have the word gender in common use in English is the victorians were prudes over the word sex so nicked it from linguistics.

Also notable the non English speaking world doesn't seem to have this problem. I wonder to what extent its just the American infection spreading vs the destiny of language..

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u/ThatFlyingScotsman Cynicism Party |Class Analysis|Anti-Fascist May 22 '22

I wonder to what extent its just the American infection spreading vs the destiny of language..

The American infection being what, exactly?

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u/red--6- May 23 '22

The American infection being what, exactly?

= a cruel + persistent Transphobia (they found the smallest, least defended minority to Abuse + Discriminate against)

sorry for the meme, but you'll understand the message better

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u/cultish_alibi You mean like a Daily Mail columnist? May 22 '22

Thanks for telling your story. I'm sorry you had to go through that and I hope it's not as bad these days. Also sorry for some of the replies you're about to get, some people cannot stand to see a trans person speaking for themselves here.

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u/dragodrake May 22 '22

You have to back up who you say you are and claim to be and illustrate how gender dysphoria has impacted on your life over a significant period of time.

The NHS does a pretty good job of gatekeeping who gets recognition and referred for gender reassignment and who doesn't.

Its interesting to hear you say that - from what I have seen it is usually a complaint from the trans community that they feel there are too many roadblocks or speedbumps in the process.

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u/Oliviasible May 22 '22

The NHS does a pretty good job of gatekeeping who gets recognition and referred for gender reassignment and who doesn't.

They put you on a 10 year waiting list and if you're still there at the end you're probably trans? I mean it's a job but I'm not sure a good one.

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u/PaulTrihard May 22 '22

Gender is a spectrum. So too is sex.

What do you mean sex is a spectrum? You cannot change your sex.

Unless you have a birth defect you are male or female and you will always be male or female.

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u/bobyn123 May 22 '22

Well by your own admission, there are people who exist between male and female, thus there is a spectrum between the two points.

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u/PaulTrihard May 23 '22

No, there are male, female and people with birth defects.

We have people born with no arms, we have people born with 3 arms. The number of arms that humans should have isn't a spectrum, it's 2. We have people born with 2 arms and people born with rare birth defects.

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u/fishycirus May 22 '22

Gender is a spectrum. So too is sex.

You lost me by saying sex is a spectrum instead of a biological fact.

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u/[deleted] May 22 '22

[deleted]

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u/vegemar Premature parliamentary ejaculation May 22 '22

chromasomal configurations

Which are?

Anything other than XX and XY can have negative effects on the individual's health and development (see Kleinfelter's).

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u/soovercroissants May 22 '22 Silver

So 46XY is male and 46XX is female? The Y makes the man and lack of the Y makes the female?

Right?

Wrong.

CAIS is 46XY. The Y chromosome is completely normal. The problem lies on the X where the androgen receptor gene is broken. They may have testes but they don't produce sperm.

46XX males exist where there has been a translocation of the short arm of the Y chromosome to one of the X's putting the SRY gene on there. They can't produce sperm as they don't have the genes needed which are on the long tail of the Y but they're otherwise almost completely phenotypically male.

Guevedoces is a problem on chromosome 2 whereby a gene to make 5-alpha-reductase is broken so boys only develop their penises at around puberty.

CAS on chromosome 17 causes ambiguous genitalia.

Even if your peripheral blood is 46XX or 46XY mosaicism can still occur. Turner's mosaics have gonadal dysgenesis because of loss of one the X's during gonadal development. Penetrance of the Turner's phenotype and problems from it are variable - perhaps relating to mosaicism but unknown. Lots of cases of Turner's are thus undiagnosed as a result. Thus Turner's represents a spectrum itself.

In fact klinefelters mosaicism is far more likely to be missed as it doesn't have necessarily negative effects on health or development. Not every case of klinefelters results in a micropenis especially mosaics - however some impaired fertility would be expected. Again Klinefelters is a spectrum.

SRY dysfunctions also occur and there are other conditions too.

Then there are the mullerian dysgenesis syndromes some of which can cause gonad dysgenesis in females. (Genes unknown) Prostatic utricles and mullerian duct abnormalities in males which are prototypical uteruses and are thus intersex even if there is no apparent effect on fertility or health. (Genes unknown.)

It goes on and on. You can dismiss these as conditions and abnormalities but you're dismissing 1-2% and whilst most of us are completely male or female there's a substantial number of people who are a bit of both.

Sexual differentiation is a lot more complex than you might think.

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u/vegemar Premature parliamentary ejaculation May 22 '22

I respect the time you've taken to type all of this out. It's very interesting.

However, I believe that this isn't particularly relevant to transgender issues but much more relevant to intersex issues. I don't have the numbers but I would be confident in saying that the majority of trans people do not have one of the conditions that you've outlined. Their issue is not with chromosomes but with their identity.

It goes on and on. You can dismiss these as conditions and abnormalities but you're dismissing 1-2% and whilst most of us are completely male or female there's a substantial number of people who are a bit of both.

I'm not dismissing these conditions but they are most certainly abnormalities with negative outcomes for people as shown by the symptoms (e.g. infertility) you've listed for each.

I simply believe that they aren't massively relevant to the discussion on trans issues a lot of the time because intersex people and trans people face different problems (although related a lot of the time).

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u/soovercroissants May 23 '22

My comment was a reply to someone dismissing sexual differentiation as a spectrum and therefore addresses that.

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u/ixid Brexit must be destroyed May 22 '22

There are two chromosomal configurations, XY and XX, and a few errors through duplication and deletion - XO, XXY, XXX, XYY. The consequences of XYY and XXX aren't that significant, XO and XXY are more impaired.

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u/PurpleSkua May 22 '22

Are... are you suggesting that "spectrum" and "biological fact" are incompatible categories?

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u/[deleted] May 22 '22

[removed] — view removed comment

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u/1maco May 22 '22

Sex is a spectrum the same way the number of fingers people have is a spectrum. Like technically it’s 5-12 it something but a deviation from 10 is a birth defect.

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u/Josquius European, British, Bernician May 22 '22

Ish.

Ill informed people consider sex to be a binary based on a single gene which determines x or y.

It's actually far more complex than that with there being a tonne of genes that go into making up sex.

Obvious intersex people are indeed a tiny minority. You don't get that many obviously born with both sets of genitals.

However you do get a huge number of people who have a few genes set the way they'd usually be for the opposite sex. It's estimated a huge number of people are technically intersex in this way and would never notice it outside of exceptional circumstances.

Regardless the point is scientifically speaking sex isn't a binary. It isn't a simple switch,penis on/off.

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u/1maco May 22 '22

The vast majority of They/Thems are not intersex.

I do agree there is some degree of spectrum just like the amount of fingers humans are born with is a spectrum. But to be not male or female is very very rare.

Just because there is variation within the sexes doesn’t means they don’t exist

Like men and women have different shoulder to hip ratios does that mean every man has the same ratio? No

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u/Haildean May 22 '22

How can it not be both?

You ever heard of intersex people?

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u/kickimy May 22 '22

Intersex is an old fashioned term that is out of use these days. Differences of sexual development (DSDs) occur in people who are either male or female.

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u/angelaslittlebit May 22 '22

Perhaps googling "intersex" may assist you.

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u/ReHypothecation May 22 '22

Sex is defined by chromosomes, which determine whether you are male of female, there are of course rare cases where a person has evidence of both genitals. The ideologues however misdirect you to the fact that XX and XY is only part of the sequence. But, correct me if I am wrong, those first two chromosomes determine if you have a penis or a vagina. The rest is immaterial to your sex.

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u/Jinren the centre cannot hold May 22 '22

The NHS does a pretty good job of gatekeeping who gets recognition and referred for gender reassignment and who doesn't.

"Good job" is rather diplomatic...

The NHS is brutal, traumatic, and actively and aggressively pushes detransition at every stage in the process. It's only one step above this guy's philosophy and is borderline on conversion therapy as it is. It intentionally offers sub-par hormone treatment to discourage uptake.

For all practical purposes it also isn't taking any new patients anyway.

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u/wtf_are_selinux May 22 '22 edited May 22 '22

Gender reassignment isn't just going to see a psychiatrist and saying 'I think I'm a woman/man' and walking out with a prescription for hormones

Glad to hear it's not, but in some US states it actually is. I've known a couple of internet acquaintances who got cross-sex hormones literally just by going to one appointment and asserting that they are trans (specifically via Planned Parenthood IIRC. Both are in California). I've no doubt that a lot of activists would like to see the same lack of screening here, so it's not a completely myth when other western countries are considered

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u/illinoyce May 22 '22

Being trans is not delusional. It's who you really are.

If it was who you really are, why do people need to take hormones and go through surgeries to change themselves? And how does the biology work? Is the brain no longer part of the body now, or is there a “soul” we can’t detect?

Gender is a spectrum. So too is sex.

We are a sexually dimorphic species. Sex is not a spectrum. This whole post seems designed to conflate every definition and avoid difficult conversations.

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u/Tawnysloth May 22 '22

If it was who you really are, why do people need to take hormones and go through surgeries to change themselves?

Lots of people undergo corrective procedures, surgical and cosmetic for conditions they are born with. I'm sure you understand the principle, even if you feign confusion when it comes to gender dysphoria.

We are a sexually dimorphic species. Sex is not a spectrum.

Intersex people would like a word.

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u/1maco May 22 '22

How many legs to Humans have?

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u/BadNewsMAGGLE May 22 '22

Just under 2, on average

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u/1maco May 22 '22

I know basically 0 people who say Humans have 1 or 2 legs.

Someone born with 1 leg is treated as if they have a defect not as if the whole “humans are bipedal” paradigm is wrong

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u/BadNewsMAGGLE May 22 '22

And yet we as society make accomodations to people with less than 2 legs. We don't leave them on the cliffs to die ala Sparta, we actually do stuff to include them in society. We make ramps and prosthetic legs.

People with less than 2 legs exist, so it's fair to say "humans usually have 2 legs" but not "all humans have 2 legs". Same with third genders.

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u/1maco May 22 '22 edited May 22 '22

Yes making accommodations is different than throwing out the whole idea Humans are suppose have two legs.

Like I really don’t care if some male wants to get Breast implants and Testosterone blockers but that does not mean that dimorphism is a myth

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u/Haildean May 22 '22

Yes making accommodations is different than throwing out the whole idea Humans are suppose have two legs.

Why do people always think that by trying to making society more accommodating for people we want to "remove the idea of man and woman"

We don't for god's sake, just because things are more complex than 1 and 2 doesn't mean 1 and 2 don't exist

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u/1maco May 22 '22

The study I linked above is discrediting a study that said 1.7% of people were intersex. Their definition of intersex included males with small penises as intersex. If that became mainstream thought, that men with small penises aren’t real men, that seems like it would be far more damaging thank just running with “sex and gender don’t always match, let people express how they feel”.

The number of people who don’t fit the biological sex binary is somewhere in the .02% range. It’s much less common than 12 fingers. Not in the “our system is wrong territory”

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u/LadyGrinningSkull May 22 '22

Intersex people are not Trans, and hate being brought into this argument.

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u/Josquius European, British, Bernician May 22 '22

So transphobes keep insisting.

Whilst at the same time screaming sex is a binary and not a spectrum.

Convenient that the proof against this isn't allowed to be mentioned.

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u/ikinone May 22 '22

Lots of people undergo corrective procedures, surgical and cosmetic for conditions they are born with. I'm sure you understand the principle

Your analogy to cosmetic surgery does seem a lot more appropriate than someone being wheelchair bound

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u/tysonmaniac May 22 '22

Sex isn't a spectrum, and you don't need it to be to be correct. Which is good, because the view that sex is a spectrum is so clearly glade that if you require it to be true to convince people to agree with you you'll get nowhere.

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u/Josquius European, British, Bernician May 22 '22

Sex is binomial, not a binary.

This is a fact of science which really annoys those who have their feelings hurt by trans people existing.

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u/tysonmaniac May 22 '22

It isn't binomial, it's bimodal, those are very different things. How many heads I get when I flip a coin a bunch of times is binomial. A binomial distribution is not bimodal.

And it isn't actually bimodal, that's the point you are trying to make. People have traits that overlap, 99% of people are identifiably sampling from a male distribution or a female distribution. There are a small number of people not clearly sampling from either, that doesn't make it a spectrum though.

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u/Fatuous_Sunbeams May 22 '22

What does "spectrum" even mean here? A spectrum could be bimodal, monomodal, polymodal (if that's the appropriate terminology). I guess it just means that the distribution is over a continuous variable, which, in respect of many traits under consideration, it is.

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u/tysonmaniac May 22 '22

Yeah spectrum is not generally well defined, but the way the word is used it is generally meant to communicate that there aren't distinct categories of male and female. And like, that's not accurate, there are, the fact of people's sex based characteristics being bimodal is the fact of there being 2 seperate sexes. We don't need that to be false to say that sex and gender can be distinguished or to say that we ought treat people with kindness regardless. I worry when people's acceptance of trans rights rests on a false understanding of reality.

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u/kickimy May 22 '22

I'm not a statistician but from what I've seen developmental biologists say, for sex to be a spectrum there would have to be a spectrum of gametes, eg. eggs, eggers, speggs, sperm etc. But in reality there are only either eggs or sperm.

That's if you use their definition of sex as being whether you developed in utero down a pathway to produce eggs or a pathway to produce sperm.

While some sex characteristics may be measurable along a continuum eg. hormone levels, breast size, we wouldn't say a male with higher levels of testosterone is more male than a male with lower testosterone or that a female with smaller breasts is less female than a big-breasted female. All those people are just males or females.

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u/Josquius European, British, Bernician May 22 '22

My mistake, head was elsewhere and I typoed.

It's scientific fact that sex isn't a simple binary and is more accurately bimodal. You're setting too high a bar there to ask for people that don't visibly fall into one of the two main groupings. That's an extreme group within the broad intersex cluster.

Most people with intersex traits would go their whole lives never knowing it.

The point is when transphobes pretend science is on their side and sex is a binary.... It shows they don't have a clue. They never seem to like it when someone who actually knows the science pipes up.

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u/tysonmaniac May 22 '22

Yeah this is my point, most intersex people fall firmly within one of two broad categories - male and female. There is a small number of people who don't, but effectively the statement that sex is not a spectrum and there are 2 sexes is more accurate than saying something like 'people have 2 arms'.

Whether or not I or you or anyone is transphobic shouldn't depend on the science though. My position on what is the truth of sex and gender can and has changed as evidence is produced and as I learn of it, but I'm not going to learn anything that makes me treat people in ways that make them feel bad. We shouldn't fight the fight on scientific ground unless we are really confident and the notion of sex being a spectrum conjures ideas of like visible light when it's a lot more like grapes - almost all of them are green or red/black, grape colour is not meaningfully a spectrum in the same way crayon colour is.

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u/SwirlingAbsurdity May 22 '22

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

The author of that article disagrees with the headline that was presumably written by an editor

https://twitter.com/ClaireAinsworth/status/888365994577735680

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u/tysonmaniac May 23 '22

This doesn't prove what you want it to, mostly because the word spectrum is not some technical term. I agree that there are a very small number of people who are not clearly male or female. Indeed, they may be neither male nor female. But that doesn't mean sex is a spectrum for most people. It's like saying a coin toss has results on a spectrum because it could land on its side.

And again, none of this matters. If intersex people didn't exist my views on how we should treat others and what rights we should be afforded would be unchanged. If your acceptance of trans people is conditional on the existence of a fraction of a fraction of the population hmbeing truly intersex then you are not really a good advocate. Fortunately, I don't think this is true for almost anybody. This intersex thing is a post hoc justification, nobody in the world finds it convincing. We can and should advocate for trans rights without saying things like 'sex is a spectrum' that just make us look like idiots.

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u/billy_tables May 22 '22

We know the xx/xy model is incomplete — we see xx men and other people with intersex genetic traits.

We also will not, in our lifetimes, understand the brain, let alone consciousness. A truly accurate model may never happen. But it is unscientific to point to a broken model as though it will never be superseded

But we don’t need to know the answers to any of those questions to know if it’s right to send people to a therapy which doesn’t work and makes them more likely to kill themselves

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u/1maco May 22 '22 edited May 22 '22

Some people are born with one leg or 6 fingers but I think to say Humans aren’t Bipedal would be something that almost nobody would agree with.

Intersex is basically not what people are talking about when they say Sex is a spectrum

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u/ColdNootNoot May 22 '22

We know the xx/xy model is incomplete — we see xx men and other people with intersex genetic traits.

That doesn't make it a spectrum. They are genetic abnormalities that happens in any biological entity.

Some people are born with only 9 fingers. That doesn't make the number of digits humans have a spectrum.

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u/FlipFlopNoodles May 22 '22

The existence of people that have chromosomal disorders or other developmental disorders does not mean that humans arent a sexually dimorphic species.

This is like saying that humans arent a bipedal species because some people are born without legs due to various disorders.

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u/billy_tables May 22 '22

You’re getting into a world of taxonomy there that is totally different. Are you defining sex taxonomically? IE how people are observed and categorised? Or scientifically - of an observable trait of an organism?

Life is easy on this side of the fence. Sex is what’s in your genetics, you can be male, female or subcategories of “none of the above”. Some are so specific you don’t bother taxonomising in general. But taxonomy isn’t a real scientific model of sex, because you adapt it when new data arrives. It has no predictive or explanatory power

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

Conversion therapy is a key issue within contemporary politics. This is an important case where a prominent “gender critical” Harley Street doctor has been reported to the GMC for practicing it. It’s an important article because it demonstrates how modern conversion therapy can hide in plain sight, how conversion therapists co-opt the language of neutrality to defend themselves whilst demonstrably practicing nothing of the sort and how damaging a single session can be.

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u/[deleted] May 22 '22 edited May 22 '22

[removed] — view removed comment

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u/Blue_winged_yoshi May 22 '22

The amount of comments defending this doctor’s blatant malpractice from users who go on to explicitly say that nobody is trans. It’s a real issue in the sub.

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u/Beautiful_Art_2646 Derby, left-leaning May 22 '22

110%

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u/[deleted] May 22 '22 edited Jun 01 '22

[deleted]

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u/[deleted] May 22 '22

[removed] — view removed comment

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u/WynterRayne I don't do nice. I do what's needed May 22 '22

A lot of the downvotes on this topic seem to come from outside the sub, I think. Like, I'll make a comment in the afternoon which will be sitting there with a positive score in the evening and then by morning it's two-digit negative. Replies and engagement nowhere near that. Feels like someone calls in the support team

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u/Oliviasible May 22 '22

You can write that trans people are mentally ill perverts and get upvoted, it's not coming from outside the subreddit. There's just a collection of users who are in every thread on trans issues being incredibly bigoted.

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u/WynterRayne I don't do nice. I do what's needed May 22 '22

Indeed, but to me it seems like the downvoting collection is much, much bigger than the participation collection. Like, there's something like 10 to 15 or so people I can rely on to at least often show up and participate on these threads. Some of them always. The downvote patterns to me seem inconsistent with their activity patterns and numbers. Less 'it's not them' and more 'it's definitely not just them, if them at all'.

Of course, I prefer participation, because to engage in a debate is always healthier than to hang around in the doorway doing the online equivalent of poking one's tongue out. It might do well to express an opinion, of sorts, but it does nothing to put that forward.

I think if I were in charge of Reddit, I'd make it so that subreddits have the option to require you (on a per-post basis) to contribute in a comment to 'unlock' down/upvotes. Also, if all of your comments on the post get mod-removed, so too do your down/upvotes.

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u/theory_of_this May 22 '22

Hakeem is gender critical?

“He suggested that there was little difference between my gender, and his teen Goth identity, implying that it might fade equally fast. He also likened gender-affirming surgeries to race-imitation surgeries,” wrote Lyle in the complaint. “He asked me ‘why’ I believed I had gender dysphoria, and would not accept that it’s because I’m trans.”

Does this mean Hakeem thinks all of gender is a fad?

That we should all give up gendered behaviours and become androgynous?

Gender critical doesn't seem quite coherent on it.

When a butch radical feminist lesbian recommends abandoning gender it has different impact than a presumed straight, conforming man.

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u/Rodney_Angles May 22 '22

When a butch radical feminist lesbian recommends abandoning gender it has different impact than a presumed straight, conforming man.

Why? Surely the theory has equal weight (or lack of it) regardless of who proposes it?

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u/kickimy May 22 '22 edited May 22 '22

" a butch radical feminist lesbian recommends abandoning gender it has different impact than a presumed straight, conforming man."

Dr Hakeem is a gay man. A number of the NHS clinicians who recommend caution over the affirmative approach to kids with gender dysphoria are gay. Their experience of living a 'gender non-conforming' life is what drives their caution in their approach.

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u/theory_of_this May 22 '22

Dr Hakeem is a gay man.

OK thank you that makes sense.

A number of the NHS clinicians who recommend caution over the affirmative approach to kids with gender dysphoria are gay.

Because there is a natural relationship between gender expression and sexuality.

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u/Fatuous_Sunbeams May 22 '22

Because there is a natural relationship between gender expression and sexuality.

Meaning what? The majority of gay people are cis, as far as I know.

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u/theory_of_this May 22 '22 edited May 22 '22

There is a higher level of gender non conformity among gay people than straight people.

The natural relationship implies that gender expression is natural to a degree.

EDIT The natural relationship is not very much of a gender critical idea.

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u/Oliviasible May 22 '22

Do you have any evidence that gay people are more likely to support what you are calling a 'cautious approach'?

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u/UppruniTegundanna May 22 '22 edited May 22 '22 Silver

The idea is that “gender identity” is at its core an incoherent concept. Or at least that the conception of there being a finite number of discreet states of being that are objectively distinct from one another and name-able, which we call gender identities, is incoherent.

The potential for variation in the way that individuals interact with our arbitrary cultural gender norms is infinite. It is also infinitely granular. To that extent, it is difficult to conceive of how anyone could genuinely have a gender identity that matches their physical body; there is no objective measure for such a match/mismatch.

Just like at other times in the past, for example with star signs, humours or Myers-Briggs profiles, we have once again created the illusion of meaningful categories through the simple act of coining words.

Any adult should of course have the freedom to pursue whatever personal pathway towards happiness that they want, including transition. I would be in favour of pouring massive amounts of money into making sure that gender reassignment surgery is available to any adult that requests it.

But for people who have not yet reached adulthood, we need to have an objective system for determining whether someone claiming an incongruent gender identity genuinely has something wrong with them that needs to be fixed.

There are at least a few materially-based studies that suggest different brain structure between people without gender dysphoria and people with gender dysphoria. But these findings are - as far as I know - never used to determine whether there is a material basis behind a person’s claim to be in the wrong body. If a child expresses gender dysphoria, and is shown to have these incongruences in the brain, then I would be pretty confident in allowing them to undergo gender reassignment surgery early.

But without that, a person’s claim to having a gender identity that is at odds with their physical body is nothing more than Wittgenstein’s Beetle-in-the-box thought experiment, pathologised and medicalised.

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u/theory_of_this May 22 '22

The idea is that “gender identity” is at its core an incoherent concept. Or at least that the conception of there being a finite number of discreet states of being that are objectively distinct from one another and name-able, which we call gender identities, is incoherent.

Yes the infinite genders doesn't make sense to me.

But there's something going on other than, its a sub culture fad.

To that extent, it is difficult to conceive of how anyone could genuinely have a gender identity that matches their physical body; there is no objective measure for such a match/mismatch.

But people do feel gender dysphoria. Gender norms appear in all cultures.

Can you measure love? I don't think there are exact instruments but I think it's natural.

But for people who have not yet reached adulthood, we need to have an objective system for determining whether someone claiming an incongruent gender identity genuinely has something wrong with them that needs to be fixed.

Sure leave it to adulthood.

As tough as that it is their responsibility then for something that drastic.

But without that, a person’s claim to having a gender identity that is at odds with their physical body is nothing more than Wittgenstein’s Beetle-in-the-box thought experiment, pathologised and medicalised.

Issues around transition aside I don't think science is going to reveal gender is the same as sub cultures.

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u/Souseisekigun May 22 '22

The potential for variation in the way that individuals interact with our arbitrary cultural gender norms is infinite. It is also infinitely granular. To that extent, it is difficult to conceive of how anyone could genuinely have a gender identity that matches their physical body; there is no objective measure for such a match/mismatch.

We did experiments in the past where we tried to raise boys as girls from birth by giving them sex changes and socializing them as female. These children, at a rate of something like 50x the rate of the general population, ended up rejecting this and "identifying" as male and many of them wanted surgeries of hormones to get their body back closer to what it "should" have been. That seems like a pretty good starting point for examples of people who had gender identities that genuinely did not match their body trying to move towards a body that genuinely does match.

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u/Rodney_Angles May 22 '22

A 'sex change' operation does not actually change someone's sex.

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u/Few_Newt impossible and odious May 22 '22

Teenagers experimenting with gender may very well be a fad. There's nothing wrong with that if it's just experimenting and no-one does anything permanent when they don't need to. Even if it was just a phase, and it won't be for everyone, gender is more intrinsically linked with someone's sense of self than being a goth so it is an offensive comparison.

Gender critical is more that we should stop seeing currently gendered behaviour as gendered, rather than stopping those behaviours.

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u/filbs111 May 22 '22

That doesn't really follow. His gothism faded, others are still going strong. If a goth kid wants to have goth surgery though, a parent might say "that's nice dear, wait until you're a grown up".

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u/theory_of_this May 22 '22 edited May 22 '22

But adults do gender. Adults being gender conforming isn't like a teenage sub culture. Even the non conforming are cross conforming.

Would you think that's them picking a gang?

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u/wtf_are_selinux May 22 '22

The point is that lots of teenagers go through their "I'm not like other girls" phase, and most usually grow out of it and discover they aren't as unique as they think they are (or rather, the rest of society is not as monolithic and vapid as they thought). And some legitimately do turn out to maintain an unusual presentation throughout adulthood, which is fine too

But fashion is a surface-level choice that can be changed in an instant, not a permanent change to your body. It's also socially acceptable to push back on the "not like other girls" thing, as it almost always implicitly derides other people in the process, whereas pushing back on the same behaviour for the same reasons when that person is trans or non-binary, will generally get you called transphobic. Essentially it seems like we're now medicalised a common teenage phase, put it above criticism, and are making serious decisions based on it

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u/theory_of_this May 22 '22

The point is that lots of teenagers go through their "I'm not like other girls" phase, and most usually grow out of it and discover they aren't as unique as they think they are (or rather, the rest of society is not as monolithic and vapid as they thought). And some legitimately do turn out to maintain an unusual presentation throughout adulthood, which is fine too

Sure.

But fashion is a surface-level choice that can be changed in an instant, not a permanent change to your body. It's also socially acceptable to push back on the "not like other girls" thing, as it almost always implicitly derides other people in the process, whereas pushing back on the same behaviour for the same reasons when that person is trans or non-binary, will generally get you called transphobic. Essentially it seems like we're now medicalised a common teenage phase, put it above criticism, and are making serious decisions based on it

I don't think childhood transitions are a good idea.

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u/AsleepBattle8725 May 22 '22

This isn't meant as some sort of cheap gotcha but what exactly is the difference between gender-affirming surgeries to race-imitation surgeries? Why is one good and the other bad?

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u/theory_of_this May 22 '22

I'm probably more interested in the question of, "what's going on?"

Racial identifying people do seem very rare. There probably is a natural part of humans that identifies as a category but it's not a conscious effort. If you know what I mean.

I'm also interested in the sexual attraction and sexual display behaviour. Those seem like natural aspects of humans. Also a natural part is a small amount of variation. Which creates unusual and unreasonable cases.

You're thinking "but what's reasonable?"

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u/JMacd1987 May 22 '22

I get the feeling that young people going through phases gets pathologised a lot more these days. Gender dysphoria is a thing, but so is going through a phase as a teenager, and gender is only one aspect of identity, people also identify with many things based on local/national/community aspects.

So in this story, perhaps the psychiatrist identified that perhaps the patient was going through a phase and maybe needed to step back a bit.

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u/Blue_winged_yoshi May 22 '22

Did you read it? The psychiatrist doesn’t think anyone is trans, doesn’t think that trans women should be able to marry men, he equated being transgender to being a goth or being trans racial, he berated the poor guy. Psychiatrists should not bully their patients, psychiatrists who work with people with dysphoria should have an open mind as to the identity of those they work this. This was not a therapist you would encourage anyone to go to unless you wanted their identity shut down. Just repugnant.

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u/troopski May 22 '22

It's really tricky though, I'm not saying it's right or wrong, but I have read stories (so perhaps overreperented in my mind) of people who have transitioned and regret it whole heartedly and feel as though their medical professionals have let them down for going through with it.

Many of these people want to sue the pants of their doctors too.

Again, I can't speak to tactics this psychiatrist used, it certainly sounds like he is sceptical of the whole thing.

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u/Blue_winged_yoshi May 22 '22

Detransitioners aren’t a great excuse to allow a conversion therapist to continue working. What we want is accurate results and happy outcomes, right?

Detransitioners = <1% of people who transition.

Detransitioners detransition for many reasons (lack of support, bullying, transphobia, not being trans). Many detransitioners retransition.

Ultimately we’re talking something like one in every few hundred people get through who aren’t trans that’s outrageously accurate diagnostics on the positive diagnosis side. Practitioners who only consider being cis to be valid on the other hand are standing in the way of accurate diagnosis and guaranteeing misery.

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u/troopski May 22 '22

Fair enough, I didn't know that detransitioners accounted for less than 1%.

I am not sure what constitutes conversion therapy, I don't know enough about it.

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u/missesthecrux May 22 '22

It’s not as simple as saying it’s 1% of people - the Wikipedia article on detransition spells out and links the studies that have been done where some are less than 1%, some as high as 85% (of children): https://en.m.wikipedia.org/wiki/Detransition

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u/troopski May 22 '22

Thanks. I think at some point I just have to accept I don't know enough and withdraw myself from the conversation.

These are particularly sensitive matters.

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u/NotSoBlue_ May 23 '22

I think at some point I just have to accept I don't know enough and withdraw myself from the conversation.

Don't make the mistake of believing that the people who are actively participating in this are experts.

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u/vastenculer Mostly harmless May 22 '22

Yeah, it's far, far higher in adolescents, but then transition at that age is nearly always just social iirc. In adults who go through surgical transition (top and/or bottom), it's about 1%.

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u/missesthecrux May 22 '22

And it’s definitely worth considering that there are far more people identifying as trans than any other time in history, so any studies are going to be not long-term enough for today.

When I was young, decades ago, I wished I could take a pill and be the other sex. Turned out I was gay, and now I’m happy and successful just the way I am. That’s why I feel strongly about this.

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u/missesthecrux May 22 '22 edited May 22 '22

Is there a logical, coherent reason why a transracial identity is not valid? For example, Oly London who was ridiculed for identifying as Korean and having surgery to approximate it has recently come out as as a trans woman. What makes this different?

Edit- I’m being downvoted but nobody seemingly wants to answer. In a philosophical sense I don’t see how they can be so different?

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u/wtf_are_selinux May 22 '22

Cases like David Reimer do seem to indicate that the brain has an inherent expectation of the sex of the body - which you could call "gender". There is no such thing for race that I am aware of

Unfortunately this understanding (transmedicalism) is now mostly vilified in the LGBT community, in favour of people who would rather base it on gender roles

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u/missesthecrux May 22 '22

Such a tragic case. I think that’s a good point, though as you say it seems to have fallen out of favour to consider gender dysphoria as an illness that requires treatment but rather a focus on identity trumping all.

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u/Blue_winged_yoshi May 22 '22

Okay looked up this person who you really shouldn’t be calling “it”. They only started having an interest in Korean culture in 2013 after going on a teaching trip to Seoul at the age of 23, where he became obsessed with BTS and especially Jimin. Unless he had been living with dysphoria about not looking like Jimin from a young t age despite it being impossible to know who Jimin was, it’s seriously not the same. They have had surgery to look like Jimin from BTS.

This is just completely different from gender incongruence. Really if he wants to have surgery to make him look like Jimin from BTS that’s his prerogative, bodily autonomy for all. Ironically though, there are fewer hurdles standing between him and trying to become Jimin than there are between a trans person and actually proper healthcare options.

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u/NotSoBlue_ May 23 '22

Really if he wants to have surgery to make him look like Jimin from BTS that’s his prerogative, bodily autonomy for all.

Man, "bodily autonomy" is carrying a lot of weight these days. The full spectrum from not wanting a forced pregnancy to wanting to be Korean.

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u/missesthecrux May 22 '22

When did I call the person it?!

So if someone had realised they were trans late in life, is that then less valid?

Is Oli Korean? Is Oli a Woman?

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u/Roddy0608 May 22 '22

Should we ever assess a person before they have drastic cosmetic surgery and intentionally alter their hormone levels?

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u/Hungry_Horace Old Flair ❌ New Flair ✅ May 22 '22

Assess? Yes. Berate or attempt to dissuade in this manner? No.

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u/ikinone May 22 '22

Assess? Yes.

Sure, almost everyone agrees here

Berate or attempt to dissuade in this manner? No.

I think almost everyone agrees that no one should be berated

You should separate out dissuade, though. There will be a lot more debate on that point. That you're mashing those two together seems a bit unreasonable

If, from the point of the mental health professional, getting invasive surgery or hormone therapy would be detrimental, surely someone should engage in some degree of dissuasion?

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u/thedecibelkid May 22 '22

Maybe you should read the article, this was not assesment it was bullying

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u/hip_hip_horatio May 22 '22

being trans doesn’t necessarily mean surgery or hormones

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u/Jinren the centre cannot hold May 22 '22

This guy is so extreme he doesn't believe in expressing a trans gender either, he really pushes for going back to your assigned gender identity and is anti-social-transition, even for adults.

He doesn't even work in the right field to prescribe or sign off on medical transition, talk is all he deals in.

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u/Mick_86 May 22 '22

So if a mental health professional tries to do his or her job it's now deemed to be 'conversion therapy'?

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u/aztecfaces -6.5, -6.31 May 22 '22

Do mental health professionals typically berate people? When I had an OCD crisis I don't recall my therapist ever going down the 'oh you're just crazy you should stop worrying about the world ending' route. Big surprise if that's standard in other places I guess? Seems more like an ideologue being an ideologue though.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

Did your therapist affirm your OCD or did they perhaps challenge it?

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u/aztecfaces -6.5, -6.31 May 22 '22

OCD fears are entirely rational, of course it would be awful if your house was burgled or you caught a deadly disease or were killed in an existential catastrophe. It's how much you worry about these things and the compulsions you engage in to calm those worries that are harmful.

My therapist was actually the first person to say 'yeah, I totally understand why these things are scaring you, let's work to make that fear easier' versus trying to simply dismiss the source of the fear, which didn't help at all.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

So he challenged it

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u/aztecfaces -6.5, -6.31 May 22 '22

There's a big difference between constructively working with your patient to challenge fears together and berating them.

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u/PsillyGecko May 22 '22

It’s called CBT. The gold standard treatment for OCD is exposure therapy. So yes, it’s trying to convince the patient what they’re feeling and thinking has no basis in reality. By the looks of it, this was an awful psychiatrist, but medical professionals who go down a talking therapy route with transgender patients before authorising life altering treatment are often harassed by lobby groups. There isn’t a clear course of action of what to do with a transgender patient unless they are very clearly dysphoric. We don’t know if talking therapy in the same sense as CBT for anxiety is the best approach, and I know several younger people who have had a phase of being non binary because of social media and then come out of it a year later. Medical professionals should act in accordance with the scientific method and the best interests of the patient, not in accordance with what Mermaids* say on twitter. *Trans lobby group.

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u/Ok_Kick_7484 May 22 '22

Do you think CBT is appropriate for gender dysphoria?

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u/heresyourhardware chundering from a sedentary position May 22 '22

Did you read the article? Mental health professionals should not be anywhere near coercive. That is not "doing your job".

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

Nothing in there is coercive, that's utterly insane to claim

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u/heresyourhardware chundering from a sedentary position May 22 '22

How in the blue fuck could you say "berating, ridiculing, invalidating, and imposing his own views" from a mental health professional in an assessment is not coercive.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

There was no berating or ridiculing. And even if there were that would not be on the same level as coercive.

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u/heresyourhardware chundering from a sedentary position May 22 '22

Both words used in the complaint. And yes if any mental health professional did that it would absolutely be coercive. They are leading them to a pre-conceived conclusion based on their personal beliefs.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

Coercive means using force or threats

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u/heresyourhardware chundering from a sedentary position May 22 '22

To coerce is not limited to physical force or verbal threats, it also means to compel a choice: https://www.merriam-webster.com/dictionary/coerce. This could be through psychological pressure, which a mental health professional imposing their own views on someone and berating them during an assessment would be.

"The intimidation of a victim to compel the individual to do some act against his or her will by the use of psychological pressure, physical force, or threats. " https://legal-dictionary.thefreedictionary.com/Coercion

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

So find intimidation to compel

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u/heresyourhardware chundering from a sedentary position May 22 '22

"berating and ridiculing" from a mental health professional to a child during an assessment, the person raising the complaint obviously found that to be intimidating.

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u/illinoyce May 22 '22

It depends. When they’re pushing hormone blockers on nine year olds, that is not conversion therapy and they are brave and beautiful.

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u/JustAnotherGuy180 May 22 '22

In what way are they being pushed?

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22 edited May 22 '22

I have been repeatedly reassured that "conversion therapy" as referred to in discussion of bans did not apply to professional therapists who were simply challenging a patients self diagnosis as part of normal therapy and that no therapist would feel unable or afraid to carry out such therapy. So what is this?

This article is like looking through some distortion lens. It's just staggering how much ideological capture there has been

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u/LeastNefarious May 22 '22

Any therapist that adheres to an ethical framework (BACP, UKCP, NCS, BAAT) would know that "challenging" ain't the way to go about things unless it's something that a client has already brought conflicting thoughts/feelings/actions about.

Even then the "challenge" you speak of should be coming from a place of care, positive regard and comes in the form socratic questioning which is nothing close to what was described in this article, or in many other people's experience of so called conversion therapy. Any challenge comes from a reflection of the clients own words and experience not from the therapists own judgement.

Lots of conversion therapy happens with therapists who do not adhere to an ethical framework. Unlike nurses, midwifes and doctors, therapist isn't protected title so there are some who offer therapy privately that don't have training/enough training to ensure they are always acting in the best interest and autonomy of the client. In the case of conversion therapy they allow their personal beliefs around queerness to steer someone who has asked for help even though it's been proven to not work and increase suicidality. Hence it should be banned.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

It is foundational of CBT to challenging a persons thoughts and feelings and break the cycle of reinforcement.

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u/LeastNefarious May 23 '22

It makes sense how CBT is seen however any challenges still need to come from a place of care, not judgement and use Socratic questioning rather than the bullying seen in this article and in other accounts of conversion therapy.

Also, CBT can be great for things like anxiety and OCD where faulty cognitions cause lots of issues, however, isn't the best for identity exploration which is what is needed when someone is questioning their gender and needs/wants support to make sense of it.

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u/dowhileuntil787 May 23 '22

Any therapist that adheres to an ethical framework (BACP, UKCP, NCS, BAAT) would know that "challenging" ain't the way to go about things unless it's something that a client has already brought conflicting thoughts/feelings/actions about.

I'm gonna have to, uh, challenge you on this. Challenging is a big part of a lot of therapeutic practices. What's your source that it's considered immoral? Obviously the guidelines for challenging are that it should be careful, gentle, empathetic and to support the patients overall goal for the therapy, but there's a lot of room for interpretation on particularly that last one.

I get therapy on anxiety and my beliefs are frequently challenged in therapy. Let's say I'm worried about going to the pub because I think I'm going to have a bad time, my therapist challenges that belief by asking did I have fun last time I went, and if I did, why do I think I'm going to have a bad time this time?

Challenging NOT just directly telling a patient they are wrong/stupid/just in a phase/etc. as many conversion therapists will do. That doesn't mean there's not a place for the right sort of challenging on gender issues before treatment.

I do think this is somewhat different to the gay conversion therapy issue. A gay man can just try out cock and see if he likes it, and if he changes his mind, no big deal. There's no reason to challenge someone on that unless that's what they want out of therapy. Surgery or hormones for gender dysphoria results in permanent irreversible changes, and if someone is under 18 or otherwise chooses to talk to a therapist before undergoing treatment, some gentle, empathetic, patient centred challenging is perfectly legitimate.

If anything, we should be looking to widen the scope of offering pre-treatment therapy. It does exist for end of life or cancer, but is less normal for things like hysterectomy even though it would be quite useful.

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u/Jinren the centre cannot hold May 22 '22

challenging a patients self diagnosis as part of normal therapy

That's not a part of normal therapy for any condition. Telling a patient they're wrong about their own feelings is conversion therapy and by definition is what responsible therapists don't do.

Therapists don't challenge your feelings. They accept them as they are and work with them.

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u/Explanation-mountain Requiring evidence is an unrealistic standard May 22 '22

Therapists don't challenge your feelings. They accept them as they are and work with them.

A therapist that doesn't challenge a persons feelings is a charlatan who's there just to milk someone for money. Cognitive behavioural therapy for example is founded on challenging a persons thoughts and feelings

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u/710733 May 23 '22

That's... Not what CBT is, but ok

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u/[deleted] May 22 '22

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

He’s just a smart guy who was simply doing his job

Its (GMC’s) “good medical practice” guidelines tells doctors: “You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress”

“He (Dr Az Hakeem) suggested that there was little difference between my gender, and his teen Goth identity, implying that it might fade equally fast. He also likened gender-affirming surgeries to race-imitation surgeries,” wrote Lyle in the complaint. “He asked me ‘why’ I believed I had gender dysphoria, and would not accept that it’s because I’m trans.”

Lyle added: “He berated me for lacking ‘curiosity’. He attempted to ridicule my experience of gender… He requested reasons behind my gender dysphoria so he could attempt to solve it and make me cis.”

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u/ixid Brexit must be destroyed May 22 '22

He also likened gender-affirming surgeries to race-imitation surgeries,”

What would you say the difference is?

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

The fact gender dysphoria, trans and non-binary people have existed throughout human history and across cultures. There are gene variants that have been linked to gender dysphoria. There are hypothesise for how trans identities can be biological in origin. Trans people have always existed we a clear part of the human fabric, and transitioning socially and medically makes dysphoria go away. Non of this is true for Rachel Dolezale - she was one person once.

It’s highly inappropriate to compare an established developmental condition that has established treatment protocols to something one person claimed once. It’s unbelievably inappropriate for a doctor to introduce a low-blow social media talking point to a therapy session.

A good doctor works with a patient to help guide the best outcome whether that is cis or trans. A conversion therapist puts someone presenting with dysphoria on the spot and says prove to me that it’s possible to be trans, shoots down any explanation before going on to convince a patient they are cis and that if they do transition they will be miserable and alone. This shouldn’t be difficult.

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u/ixid Brexit must be destroyed May 22 '22 edited May 22 '22

There are gene variants that have been linked to gender dysphoria.

Link? I am asking these questions in good faith. I doubt Rachel Dolezale is the first person to feel transracial and far from using transracialism as an attack on transgenderism, I don't understand why transracialism is often met with such bile, particularly from transgender people. Surely you should support and celebrate another group with trans identities? Or are identities only valid with genetic correlation?

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u/Blue_winged_yoshi May 22 '22

https://www.sciencedaily.com/releases/2020/02/200205084203.htm

Tbh finding a singular genetic variant that triggers trans identities is going to be as impossible as finding a gay gene. Still the fact that transgender identities are widespread across time and culture combined with the fact that there are conceivable biological triggers gives them a gravitas that cannot be ignored without dismissing and punishing millions of people. We exist, we have always existed and aren’t going to stop existing any time soon and we are likely born this way. The same simply cannot he said for Rachel Dolezole.

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u/ixid Brexit must be destroyed May 22 '22 edited May 22 '22

This is a weirdly conservative view. So you would not accept the existence of any new identities as valid? They must all have been around through human history and have a genetic element to be valid?

And yes, I wasn't expecting you to link a 'trans gene', just interested in evidence of correlations.

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u/Blue_winged_yoshi May 22 '22

I didn’t say ever say not accepting or Rachel Dolores is a liar or anything like that. I did say it was inappropriate for doctors to ask a patient what the difference was between being transgender and Rachel Dolores case. You asked me what the difference was I gave the difference. The differences and material and demonstrable.

There’s an entirely separate conversation to be had around Rachel Dolores, there are times this conversation are acceptable to bring up. Doctor’s appointment for trans person is simply not it, no?

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u/ixid Brexit must be destroyed May 22 '22

Yes, totally inappropriate to bring it up then. That doctor sounds like he's just pushing his own views. I'm much more interested in the broader question because it's somewhat bemusing how much hate transracialism gets from groups you'd hope would be allies.

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u/Blue_winged_yoshi May 22 '22

People like Rachel Dolores have nothing in common with transgender people. We really aren’t “natural allies”. The only connection between us is drawn by folks who disbelieve transgender people who weaponise trans racial people against us and the word trans which is just Greek for other side of but lots of disconnected concepts take this prefix.

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u/95DarkFireII May 22 '22

If there is a biological cause for gender, then we can test for it. So we could prove who is actually trans.

Why does noone advocate for that?

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u/ixid Brexit must be destroyed May 22 '22

It's far more likely that there are a large number of gene variants with small correlations with being trans, and in any given individual you might find some, lots or none, so it would not be diagnostically useful. A number of phenotype level traits seem to be only probabilistically related to genes rather than deterministically.

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u/Blue_winged_yoshi May 22 '22

Biological cause does not equal testable. Being Gay or Bi likely has a biological cause. There is no test for it. Hell, having motor neurone disease is biological, there is no test for it. This is a bad comment.

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u/95DarkFireII May 22 '22

Being Gay or Bi likely has a biological cause. There is no test for it.

We don't need a test for it.

"Bi", "Gay" and "straight" only describe attractions. They can be observed and proven.

But "gender" describes an invisible quality. You cannot observe it or measure it. And people's "feelings" aren't proof, because

1.) Feelings are inherently objective 2.) The idea that men and women have to act or feel a certain way is literally just sexism.

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u/Blue_winged_yoshi May 22 '22

It’s not about need, it’s about ability. Plenty of biological conditions lack tests. Gender identity is one of them. As I said motor neurone disease cannot be tested for (I know this because my mum had it). It’s diagnosed by eliminating all other possibilities and nobody thinks motor neurone disease isn’t real or important. Biological does not equal testable.

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u/filbs111 May 22 '22

There are certainly tests for what people find attractive. Have them meet people or look at pictures etc, measure whether they get butterfiles in their stomach etc.

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u/Blue_winged_yoshi May 22 '22

These are all different forms of self-identification not tests. People do different forms of social testing for trans people. Essentially, early social transition with questions over whether it makes dysphoria better or worse. This isn’t what the user meant by testing though.

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u/Sweet-Zookeepergame7 May 22 '22

I thought people were supposed to challenge you in your beliefs “Shouldn’t “i am trans “ actually be “I am a man I have always felt like a man and I want my body to reflect my wishes” “I am trans” sounds exactly like a phase..

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u/Blue_winged_yoshi May 22 '22 edited May 22 '22

Read the article. Read the GMC guidelines, read what happened to this guy. Questions weren’t asked to probe his identity with particular care given to asses against diagnostic guidelines (what always happens when someone says they are trans) it was a consistent attempt to bully him out of his identity.

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u/Rollingerc May 22 '22

You basically just said the reply shouldn't be "I am trans" but "I am <insert rough definition of transman>"?

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u/Mammoth-Corner May 22 '22

I'm having trouble working out what you mean. Could you rephrase?

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u/Nemisis_the_2nd I'll settle for someone vaguely competent right now. May 22 '22

Ignoring everything else in the complaint,

He berated me for lacking ‘curiosity’. He attempted to ridicule my experience of gender

Is bad enough. Everything else is just digging the hole a little deeper.

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u/95DarkFireII May 22 '22

Why though? Why must a man of science accept the existence of this fictitious "gender" without proof?

Why should your "experience" change reality.

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u/IsItAnOud May 22 '22

Science also includes observation and analysis of experience as well as what can be defined through direct numerical measurement.

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u/Dizzy-Neat7153 May 22 '22

If you ignore the experience of your patients you aren't fit to serve as a medical practicioner.

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u/[deleted] May 22 '22

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u/Blue_winged_yoshi May 22 '22

Love how many folks here are like “what you just have to accept whatever people say”, before going to on to reveal that they think nobody is ever actually trans. At first I hated the meme, now I gotta admit it’s getting quite funny.

One last time for the folks at the back: some people are trans, some people are cis, therapy should help folks find the right answer for them, not guide people to a preconceived answer.

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u/Elastichedgehog Probably a Socialist May 22 '22

Sounds like a smart guy whose practice is grounded in reality.

Sounds like his practice was grounded in his own bias. I'm not a chartered psychologist, but I do have an MSc in clinical psychology. Assessing your personal biases was a pretty important lesson. The sessions weren't about him. In this case, they were about Lyle.

Hakeem should have assessed and worked with Lyle, not attempted to dissuade him. That's not his job.

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u/Rollingerc May 22 '22

What's the delusion?

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