Friday, June 29, 2007

More Argument By False Authority

It appears that NARTH is at it again. This time, we find them quoting a psychiatrist on gender identity issues - of course in a manner intended to deride and denigrate transsexuals as illegitimate people.

Follow things far enough, and you find the NARTH article linking to an opinion piece on MercatorNet, a "newsmagazine", with a suspiciously overt Christian Conservative slant to its articles. Why an organization like NARTH that is ostensibly about research would like to what is so obviously pure opinion is beyond me, but link they did.

The article itself is rather long winded, and boils down to "we shouldn't provide gender transition as a treatment for transsexuals, we should treat them as mentally ill instead".

Newsweek also avoided the other key debate about this difficult issue: whether or not transgenders have a mental illness or merely an inconsequential desire.

Since the term "transgender" is rather broad, covering anyone who exhibits some degree of cross-gender identity - from cross-dressing occasionally to transsexuals, this is actually a very misleading statement. The Newsweek article was actually quite specifically focused on transsexuals.

If you are talking about non-transsexuals, then yes, there are legitimate questions as to the degree of their cross-gender identity. (In many respects, this is no different than is often found among bisexuals, who experience varying degrees of attraction to members of either sex. Some bisexuals are primarily heterosexual, with some undercurrent of same-sex interest, others are much more fluid in their experiences of attraction.) However, since the Mercatornet article is focused upon the provision of surgical gender alignment to patients, let's be clear that they should be referring to transsexuals.

However, this is only the beginning of the writer's attempt to dismiss the validity of the transsexual narrative. By misusing the terminology, the author sets the stage to proceed with attempting to invalidate that narrative by insinuation and distortion:

A few years ago I attended a program at the American Psychiatric Association’s Annual Conference. An editor of the DSM was under attack for describing gender identity disorder as a mental illness. But in the course of the debate, in a remarkable display of having your cake and eating it too, the transsexual woman who argued against its inclusion was forced to admit that a DSM diagnosis was necessary after all. Why? Because otherwise people suffering from the disorder could not get their health insurance company to cover the cost of the procedures.

There is a classic error of logic being presented here. The author has attempted to spin it into the "you just need the diagnosis for money". This is false. As I have pointed out before, the DSM is a lexicon needed by medical professionals (both mental health and physicians) in order to communicate in a meaningful manner:

The mistake many people make is that they assume that a diagnostic category in the DSM actually means that someone so diagnosed is "mentally ill". The reality is that for a large number of conditions described in the DSM, the person is not "mentally ill" in the sense that they cannot function in society, but rather the diagnostic category serves primarily as part of a lexicon so that professionals can adequately discuss the particulars of a patient's case with a reasonably common understanding of meaning.

I'm rather appalled to see that Theron Bowers conveniently ignores this reality - especially when Dr. Bowers is a psychiatrist! (Of course, I should point out that Dr. Bowers does not list either sexuality or gender as an area of specialty - and those areas are unique specialties indeed!)

The author conveniently cites writers like Dr. Paul McHugh and Michael Bailey - both authors that in varying degrees seek to refute the transgender narrative. (How you refute someone's life experiences, I do not know, but they keep trying)

Although Theron Bowers does not resort to the language of religiosity, it's pretty obvious that the argument has its roots in the religion. Dr. Bowers does not speak to the clinical realities for transsexuals (such as the fact that the Standards of Care (a document which provides guidelines for treatment of transsexuals) is quite detailed about the management of these cases, and promotes a high degree of professional caution with respect to the clients.

Amusingly, Bowers cites Bailey's assertion:

However, sex researcher J. Michael Bailey in his book, The Man Who Would Be Queen, notes the decision for sex reassignment has a "rational component" and that the "large majority of boys who start out looking transsexual ultimately do not pursue sex reassignment."

Cross-gender children are rare indeed, and still relatively poorly understood. While only a handful of children that exhibit cross-gender behaviour at an early age go on to pursue gender transition, one should point out that the SOC document itself is quite clear about caution, and recognizing that not everybody who is cross-gender identified needs to transition.

However, unlike what Bowers and others attempt to infer, that does not mean that nobody needs that treatment. (Even Bailey, whose positions are generally held in some contempt among transsexuals, admits that some people legitimately need to transition and are quite successful afterwards)

I find it somewhat ironic that in order for NARTH to find pieces that back up their narrow-minded view, they have to resort to people writing opinion pieces in non-refereed publications, and riding upon the fact that the author has a PhD or MD, without actually wondering aloud whether the author has a clue about the subject at hand. (Bowers appears not to, rather relies on a bad mixture of assumptions, public policy commentary and assertions that are weakly supported at best)

It tends to reinforce the perception that these people aren't about research, and are more about forwarding a highly politicized agenda that involves the bully-boy tactics of denying others their stories.

Perhaps most amusing is the assertion that a transsexual needs psychiatric treatment, as if there is no program of treatment involving psychotherapy before surgery - a reality that exposes the lies of these people for what they truly are.

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