Monday, September 01, 2008

PFOX Gets It Wrong Again

The ignorance of operations like PFOX is amazing to me, but the depth of their ignorance when it comes to gender identity issues is astonishing to me.

Consider the following gem that popped up on their press releases page in August:

PFOX note: Obviously the child was afflicted with gender identity disorder (GID) and should have received GID counseling instead of being encouraged to dress as something he was not. Encouraging GID behavior creates unsafe schools for our youth.

(An aside - I happen to think the parents in this case are dead wrong in trying to sue the school for not enforcing dress code - the problem, and the responsibility, lies with the juvenile delinquent that was able to bring a loaded firearm to school - period.)

But, let's get back to PFOX's astonishing ignorance. PFOX argues that Larry King should have received GID counseling instead of being encouraged to dress as something he was not.

So, just what is "GID Counselling"? Well, for starters, let's wander over to World Professional Association For Transgender Health (Formerly known as HBIGDA), and take a close look at what they have to say about counselling transgender identified youth in The Standards of Care for Gender Identity Disorders V6:

V. Assessment and Treatment of Children and Adolescents

Phenomenology. Gender identity disorders in children and adolescents are different from those seen in adults, in that a rapid and dramatic developmental process (physical, psychological and sexual) is involved. Gender identity disorders in children and adolescents are complex conditions. The young person may experience his or her phenotype sex as inconsistent with his or her own sense of gender identity. Intense distress is often experienced, particularly in adolescence, and there are frequently associated emotional and behavioral difficulties. There is greater fluidity and variability in outcomes, especially in pre-pubertal children. Only a few gender variant youths become transsexual, although many eventually develop a homosexual orientation.

Okay, so clearly WPATH's standards recognize that there are significant differences between cases involving youth, and when an adult presents with gender identity concerns.

So, what do they recommend in terms of therapeutic intervention? Is it the hard line denial that PFOX seems to suggest is the case? Or is PFOX simply blowing smoke and hoping nobody catches them out?

Psychological and Social Interventions.

The task of the child-specialist mental health professional is to provide assessment and treatment that broadly conforms to the following guidelines:
1. The professional should recognize and accept the gender identity problem. Acceptance and removal of secrecy can bring considerable relief.
2. The assessment should explore the nature and characteristics of the child’s or adolescent’s gender identity. A complete psychodiagnostic and psychiatric assessment should be performed. A complete assessment should include a family evaluation, because other emotional and behavioral problems are very common, and unresolved issues in the child’s environment are often present.
3. Therapy should focus on ameliorating any comorbid problems in the child’s life, and on reducing distress the child experiences from his or her gender identity problem and other difficulties. The child and family should be supported in making difficult decisions regarding the extent to which to allow the child to assume a gender role consistent with his or her gender identity. This includes issues of whether to inform others of the child’s situation, and how others in the child’s life should respond; for example, whether the child should attend school using a name and clothing opposite to his or her sex of assignment. They should also be supported in tolerating uncertainty and anxiety in relation to the child’s gender expression and how best to manage it. Professional network meetings can be very useful in finding appropriate solutions to these problems.

In short, PFOX is grossly misrepresenting the situation. If, in fact, Lawrence King's parents had taken him to a knowledgeable therapist, they could well have found that they would be making plans for him to transition at school. The therapy process would likely encourage him to find a presentation and expression that worked for him. Especially once any concurrent and significant issues had been dealt with constructively.

Gender identity related therapy is not about denial of someone's identity, but rather it is about helping them find a path in the world that is less stressful for them ... and that includes self acceptance.


Anonymous said...

Just about the most ignorant, distorted analysis that one could contrive.

Try the APA.

MgS said...

Care to refute any of my claims?

Anonymous said...

Your whole point of reference is a transgender affirming group whose premise is that transsexualism is normal and everyone needs to be "educated" on how to treat it as such.

But GID, transvestism, cross-dressing are consider serious DISORDERS (especially in adolescents) by both the APAs...the real mental health "professional" organizations.

There is nothing to refute.

MgS said...

I reference WPATH quite intentionally - they are, to my knowledge, the only organization out there with multiple decades of experience in the treatment of transsexuals.

WPATH's Standards of Care exist in concert with the diagnostic criteria in the DSM and the ICD-10, and are firmly based on established clinical experience.

If you want to dismiss them as "affirming", that's your problem. Then your obligation is to provide other options that are as well founded in clinical experience.

Further, your emphasis on the word DISORDER in the DSM diagnostic category only serves to underscore your misunderstanding of the DSM and its application. The disorder, such as it is, arises from the severe emotional trauma that transsexuals often experience as a result of living a social gender role that is incongruent with their inner person. It is often described in terms of body being incongruent with the mind.

If you look at the APA's pages on Transsexualism, they echo the principles and guidance of WPATH's SOC.

In case you were unaware, WPATH was originally named "The Harry Benjamin International Gender Dysphoria Association (HBIGDA)", for the psychologist who first undertook actively to research and treat transsexuals.

In short, I doubt you will find an approach to treatment as well rooted in research and clinical experience as WPATH's SOC.

If you have, I'd love to hear about it.