Most recently (Monday, I believe), there was a court decision in Australia where the Family Court granted a court order allowing a 17 year old FTM transsexual to have his breasts removed.
Lurking in the middle of the article is the following paragraph that caught my attention:
But ethicist Nick Tonti-Filippini said mainstream medicine did not recognise hormone treatments and surgery as treatment for gender dysphoria. He said it was a psychiatric disorder qualifying under American guidelines as a psychosis because "it's a belief out of accordance with reality".
"What you are trying to do is make a biological reality correspond to that false belief."
The first thought that went through my head was "who is this twit?". Among other things, it's quite apparent that he doesn't understand the diagnostic criteria for Gender Identity Disorder at all, nor has he bothered to fully understand the diagnostic criteria for Delusion.
In Schizophrenia, there may rarely be delusions of belonging to the other sex. Insistence by a person with Gender Identity Disorder that he or she is of the other sex is not considered a delusion, because what is invariably meant is that the person feels like a member of the other sex rather than truly believes that he or she is a member of the other sex.
So, a little bit of time with Google turns up that the man is affiliated with a religious institute as a philosopher/ethicist:
* JP502 – Philosophical Foundations of Bioethics
* JP540 – Foundations of Christian Moral Life
* JP543 – Theological Bioethics
* JP544 – Beginning of Life Ethics
* JP545 – End of Life Ethics
* JP546 – Current Controversies in Bioethics
* JP547 – Theology and Practice of Natural Family Planning
* JP564 – Educating in Sexuality, Marriage, Family and Life
Oh ... now it starts to make sense. We have another case here of someone who is more than likely to be parroting whatever the Vatican spouts.
Sure enough, he has commented on the case in question before, when Alex was first granted hormones (again through the courts, presumably because Alex is a ward of the state).
Then there's his commentary on the most recent ruling, which is particularly galling.
NICHOLAS TONTI- FILIPPINI: Most psychiatrists who treat people with gender dysphoria don't recommend the surgery and the transsexual changes. It worries me that this young woman is to have her breast cut off with the authority of the court, when the court hasn't got, well they haven’t got the mainstream view.
SARA EVERINGHAM: How do you think this should be managed?
NICHOLAS TONTI- FILIPPINI: You've got to look at it in terms of a person who is usually not well socially adjusted and so you would need to deal with those things. So that there are beliefs there, there are attitudes there which are harmful to her, that prevent her from forming normal relationships with women.
I don't even know where to begin with how dreadfully wrong Mr. Tonti-Filippini has it. Although many transsexuals do have great difficulty with relationships, those issues are secondary to the condition, not a primary root factor.
Social adjustment is something that usually improves dramatically post-transition for those who are having problems prior to transition. The other problem I have with Tonti-Filippini's reasoning here is that he's trying to deflect attention away from the base condition being addressed - Alex's cross-gender identification - thus framing his argument in the "transsexuality isn't real" context.
When he starts from a position which denies the treatment and research from the last fifty or so years, it's no surprise that Tonti-Filippini concludes that Alex is being treated incorrectly. Not unlike the decision making of Alberta's Ron Liepert, he clearly hasn't bothered to admit to his own lack of knowledge in the area, and takes it upon himself to make pronouncements without actually investigating.
Most psychiatrists who treat people with gender dysphoria don't recommend the surgery and the transsexual changes.
Sort of true, and not entirely an accurate portrayal of the WPATH Standards of Care either. Again, I will refer to section X of the SOC, which reads as follows:
In persons diagnosed
with transsexualism or profound GID, sex reassignment surgery, along with hormone therapy and real-life experience, is a treatment that has proven to be effective.
Let's see...Alex has been living as a boy since the age of 13, and is now 17. That means that he has been living full time for 4 years, and assuming that the request for breast removal surgery was made at the age of sixteen, that's well beyond the SOC guidelines for Real Life Experience. Offhand, I'd hazard a guess that Alex has more than met the diagnostic criteria that would place him in the 'surgery is medically indicated' category. While only a handful of transgender people ever pursue surgery, that doesn't mean that surgery should not be an option to be considered.
However, I suspect that Mr. Tonti-Filippini isn't interested in doing the real research to understand the background and literature surrounding transsexuality. He's already made up his mind based on his presuppositions, and quite probably whatever pronouncements have been made by the Vatican - which is already known to be hostile to transsexuals.
It's one thing to make informed criticism of things, that's not what I see here.