Bishop Henry Returns ...

It has been quite some time since I felt a need to address something that Calgary's Bishop Fred Henry has written.  Then I happened to wander past the Calgary Diocese website and read his latest "pastoral letter" (or whatever his columns on the website are officially known as).  The title is benign enough:  "Heal the Wounds, So Many Wounds ..." 

Unfortunately, what the reader is then subjected to is possibly the most offensive screed the Bishop has written in several years.

It starts off with one of the Bishop's standard attacks on "liberalism", and then goes after Transgender people:

The cutting edge of liberal culture is the attempt to label the two created human sexes, male and female, as arbitrary and unjust impositions on humanity. This involves an attempt to separate sex from gender, that is, the biological fact (human anatomy and chromosomal cellular structure) of the two human sexes from their social and cultural expressions, which they term "gender," and which is seen as totally socially constructed and in no way grounded in nature. 

Then, using such a phenomenon as hormonal treatment and "sex-change operations," they begin to deny the very stability and reality of the two created sexes. After that, they claim that whether or not one undergoes such an operation, one's subjective feeling about what sex/gender one is trumps the physical facts of one's body. 

- See more at: http://calgarydiocese.ca/messages-from-the-bishop/1362-heal-the-wounds-heal-the-wounds-so-many-wounds.html#sthash.jjOtfvFp.dpuf

Lovely, Bishop Henry.  I see that once again you have returned to your old haunts - by attacking that which you refuse to even attempt to understand.  Are you really going to argue that chromosomes define gender?  Or that physical anatomy defines gender?  Still?

I'm going to come back to this topic in a minute, because there are a couple of other gems in the Bishop's screed that I think warrant bringing to your attention.

The soul and the body are in a master/slave relationship, the former legitimately dominating and re-making the latter. For Biblical people, the body can never be construed as a prison for the soul, nor as an object for the soul's manipulation. Moreover, the mind or will is not the "true self" standing over and against the body; rather, the body, with its distinctive form, intelligibility, and finality, is an essential constituent of the true self. 

Let me get this straight - the Bishop wishes to argue that the distinction between gender and sex that there is actual evidence for, is overruled by the mythology of a soul (which may or may not exist - I haven't seen any evidence which objectively substantiates such a claim), and somehow the "soul and body are intertwined", and therefore couldn't possibly be at odds with each other?  Sure ...

Tolerance is a working principle that enables us to live in peace with each other and their ideas. Most of the time it is a good thing. But it is not an end in itself, and to tolerate or excuse a grave evil in society is itself a grave evil. 

Oh, even better.  He doesn't quite go as far as saying it, but essentially the Bishop is saying that transgender people are a "grave evil".   Wow - that's quite a claim, Bishop.  Just what is the evil that transgender people are perpetrating?

Let's come back to the Bishop's complaint that gender and sex are inextricably linked with each other for a moment.  We already know plenty of situations where chromosomes and anatomy don't fully align, such as a woman with a 46 XY karyotype, or perhaps he'd prefer to review Swaab's 2009 paper about brain differentiation during gestation.  Either way, the Bishop's argument that chromosomes or genitalia tell the "whole story" is complete nonsense.

As for gender roles, we know those are in large part social constructs.  The impact of messages in mass media about how boys should behave or what girls should do are pervasive, as are the messages we live with in our social circles.  The effect of these in socialization is neither trivial nor easily ignored.  Yet, we have a lot of transgender people who manage to successfully transition and blend into their new social roles.  If the two were inextricably linked as the Bishop claims, this would seem to be a nearly impossible task, and yet it happens.

As for the Bishop's implicit declaration that transgender people are some kind of "grave evil", I would suggest to the Bishop that he needs to substantiate just what this grave evil might be.  What I see are a lot of people bravely living their lives as honestly as possible.  If the Bishop thinks that this is "deceptive" and "evil", perhaps the Bishop needs to be reminded of the old saw about "walking a mile in another person's shoes".   There are a good many people in the Transgender community as a whole who might justifiably take umbrage at the Bishop's attempt to invalidate their reality and lived experiences.  

An Open Letter To Margaret Wente

Dear Ms. Wente,

I thought that as a journalist you were supposed to do some research before you go writing stories.  In the case of your August 2, 2014 column in The Globe and Mail, it is painfully obvious that you haven't even bothered to try.

As a child, Lindsay Leigh Bentley desperately wanted to be a boy. She refused to wear dresses and adored going hunting with her dad. She loved sticks, guns, motorcycles and monsters. She chopped the hair off her Barbies. Her parents had to cut her own hair short because she refused to let them brush it. Her best friends were boys. In childhood pictures, she looks fierce, and tough as nails. 

These days, her worried parents would probably hustle her off to the nearest gender-identity clinic.

Had you done even the slightest bit of actual research, you would have discovered that there is very little that is so simple about the treatment of Transgender youth.  The World Professional Association for Transgender Health Standards of Care (WPATH SOC) would have been a good place to start.  (Take note of this reference, we will be coming back to it)

...But it is also the story of advocacy run amok, in which a small but militant group of activists has managed to strong-arm well-meaning people into believing that gender is not innate but “assigned,” that those who are “trapped in the wrong body” would be happier with radical hormone treatments and mutilating surgery, and that children as young as one or two should be pushed along a path whose implications they are far too young to understand.

Wow ... how many twists and lies can you put into a single paragraph, Margaret?  Let's start enumerating them:

Radical Feminism Versus Reality

The New Yorker decided to publish an exposé about the ongoing war of words between Transsexual Exclusionary Radical Feminists (TERFs) and transsexuals.

Sadly, the author spent most of their time talking about what TERFs have written about transsexuals and failed entirely to present the transsexual side of the discussion in any depth.  In fact, the entire article came across as if the transsexual community's reactions to various TERF proclamations about transsexuals were simply an overreaction.

While I have no doubt that there are those whose fury over the acts of various TERFs towards the transsexual community is such that they have made threats or been otherwise unpleasant about things.  The transsexual community is hardly uniform in its sensibility or willingness to discuss topics when they feel they have been slighted.

Such views are shared by few feminists now, but they still have a foothold among some self-described radical feminists, who have found themselves in an acrimonious battle with trans people and their allies. Trans women say that they are women because they feel female—that, as some put it, they have women’s brains in men’s bodies. Radical feminists reject the notion of a “female brain.” They believe that if women think and act differently from men it’s because society forces them to, requiring them to be sexually attractive, nurturing, and deferential. In the words of Lierre Keith, a speaker at Radfems Respond, femininity is “ritualized submission.”

One might wonder just what room for dialogue there might be when the TERF argument starts with absolute erasure of the lived experience of transsexuals.   Perhaps even more troubling is that the TERF position clearly ignores a large and growing body of evidence that does show that masculinized and feminized brains are objectively different (and that transsexuals reflect brain structures that tend towards female typical).

In many respects, it isn't the TERF's denial of the reality of transsexuals that gets people wound up.  I think if it were merely a disagreement over philosophical points of worldviews, it would be far less contentious than it is.

Unfortunately, TERF writers going back to Janice Raymond, author of a treatise entitled "The Transsexual Empire" have done their level best to erase the narrative of transsexuals.  Quite frankly, Jeffrey's latest work is really just another volley in an ongoing war where transsexuals are concerned. There is very little in it which is new, revolutionary or even evolutionary.

Whether or not "Radical Feminist" theory has any legitimate criticism of the social roles assigned to our male and female citizens is unfortunately lost in the core assumption that denies transsexuals the right to their own stories.  Jeffreys, along with the other TERF writers are blinding themselves to the growing evidence of biology and how it influences the expression of gender.  The rigidity of the TERF position is also its brittleness.  Feminism needs a new direction to evolve.  The work started so many years in the past has not been finished yet, and yet it cannot move forward without including the diversity of gender identities and roles that have emerged in the last 25 years.  I firmly believe that the TERFs like others with rigid, inflexible belief systems will become the intellectual dinosaurs in the coming years.

When Is A Policy A Non-Policy?

When it involves the Catholic Independent Schools of Vancouver Archdiocese making a policy on "accommodating" transgender students.

At first glance, this almost seems like a reasonable document.  There are lots of "The schools shall do this" and "shall provide that" statements, and it almost looks as though they made reasonably well informed effort.

Almost?  Why do I say "almost"?  Like most documents, you have to read it through a couple of times before you see the gotchas in it.

Oh The Dumbf ...

Over at "Crosswalk.com" (no, it's not a site about crossing roads), we find a Dr. White going off on gender identity in the wake of Time's June 9 article "America's Transition"  (hiding behind a paywall, a copy has appeared on Scribd here).

It's a somewhat appalling excuse for writing, especially considering that Dr. White holds a PhD.

Not surprisingly for Time, the author’s bias was thinly veiled:  “Almost one year after the Supreme court ruled that Americans were free to marry the person they loved, no matter their sex, another civil rights movement is poised to challenge long-held cultural norms and beliefs.” 

That certainly sets a tone. 

But she’s right.  Mainstream acceptance of homosexuality and the legalization of gay marriage virtually demand the acceptance of almost any other lifestyle. 

Why yes, being trans is something that people wake up and decide to be one morning for giggles.

In 1980 the Diagnostic and Statistic Manual of Mental Disorders of the American Psychiatric Association listed transsexualism as a mental disorder. That entry was later replaced by what psychiatrists called “gender identity disorder. In 2013, it was later modified to mere “gender dysphoria,” which is simply discomfort with the gender a person is living in. Quite a progression in just over three decades, moving from something to be cured to something to be enabled.

Wow... just wow.  In one paragraph, Mr. White has completely misunderstood the DSM, the purpose of it and the evolution of the diagnostic categories in it with respect to transgender people.  First, one has to recognize that the DSM is a descriptive document.  It describes a series of recognizable psychological conditions.  It does not provide any kind of statement as to what objectives treatment should pursue.

Second, Mr. White quite ignoring the work of WPATH over that time, which has evolved considerably from dealing with the polar extremities of masculine and feminine identities, having learned that a simple "transsexual / not transsexual" model simply did not describe the breadth and depth of this tiny community of people.

However, White's argument rests quite firmly on a more serious misunderstanding, and one which depends on a particular understanding of gender identity.

All seemed to be well. 

Time magazine called the case “strong support” for the view that masculine and feminine behavior can be altered.  A 1979 textbook used the case to discuss how human gender identity was flexible and plastic, and how being male or female was the product of social learning and conditioning.  Numerous psychology and sociology texts cited the case as proof that sex roles are basically learned. 

But people didn’t follow the case through to the end.  

Even with the injection of female hormones, the absence of male hormones coming from testicles, and being raised as a female, Brenda did not turn out as Brenda.  In the early 1990’s, a team of researchers caught up with the boy who had been turned into a girl to see how “she” was doing.They found that “she” was no longer Brenda.  “She” was now David – working in a slaughterhouse, married to a woman, and the adoptive father of three children. 

At the age of 14, Brenda decided to start living as a male, and at 15, was told that was indeed what “she” had been born as.  She then announced that “she” had always felt like a male and wanted to become one again.  Brenda was given a mastectomy, male hormones, and constructed genitalia.When researchers dug further, they found that the first time Brenda had been put in a dress, he pulled it off.  

When given a jump rope, he wanted to tie people up with it or whip them with it. 

At nine, he bought a toy machine gun when he was supposed to buy an umbrella. 

His toy sewing machine went untouched because he preferred to build forts and play with dump-trucks. 

He was never interested in make-up, but instead wanted to shave with his father. 

On a trip to New York, he found himself attracted to the Rockettes. 

He even felt the urge to urinate standing up. 

From this, researchers at Johns Hopkins felt they should go back and study other children who had undergone similar operations; boys who, for whatever reason, were born without full male organs, had then been fully castrated, and raised as girls.  Of the twenty-five they were able to locate, ranging in age from five to 16, every single one exhibited the rough-and-tumble play more characteristic of boys than girls. 

Every single one. 

Even at their early age, fourteen of them had already declared themselves to be, in fact, boys – against everything in how they had been raised.  

From this, and scores of other studies, Rhoads concludes that instead of thinking that the difference between the sexes is something learned, or imposed by society, it is rather something larger, something deeply rooted, in our very nature.  It’s part of who we are. It’s not a role that we take on; it’s the very nature of our being.

I get quite angry when I see these people attempting exploit the tragedy of John Reimer's life story to make claims that the case simply does not represent.  Reimer's story is a tragedy on many levels, not just its conclusions, and it offends me deeply that the religious right wing keep dredging it up to imply that transgender people are "deluded" or outright "wrong" in their self-perception.  I have addressed this in considerable detail in past posts here and here.

What the argument Dr. White is making fails to recognize is that during development, the differentiation of the body between male and female physiologies is not a singular event.  We know that genital differentiation takes place quite early in gestation but the brain differentiates takes place at a different time.

However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in transsexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no proof that social environment after birth has an effect on gender identity or sexual orientation.

Knowing this well established fact, the wrap-up of Mr. White's argument is almost laughably sloppy reasoning:

This isn’t about what might truly be, to use the term no longer in vogue, true Gender Identity Disorder.  That would be something to be treated.  It is about maintaining that gender and sex, in a healthy psychology, is not something simply between our ears, but between our legs.  Sexuality is not like a favorite color – something to be chosen, or a preference – it is hardwired into our being.  

But that is precisely what our culture wishes to ignore. 

One of the great questions in all of human thought is “who am I?”  The answer is fast becoming, “I don’t know.”  It is as if our embrace of plastic surgery has led to a sense of being plastic ourselves, stripped of any sense of innate worth or identity.  If human beings have no fixed or permanent essence, if we are “plastic” – subject through technology to alteration, enhancement, mutation, control - then we may do what we will with ourselves. 

It's funny that with all of the evidence we have that White fails to see that it is entirely conceivable that someone may well be born with a feminized brain even if their genitalia appears to be perfectly normal.   In fact, I would go so far as to argue that in fact the transsexual is doing everything possible to maintain a healthy psychological state.

Really, Dr. McHugh?

For reasons somewhat beyond my comprehension, the Wall Street Journal has decided to give Dr. Paul McHugh another podium from which to spew his nonsense.  "Transgender Surgery Isn't The Solution" is yet another attempt by McHugh to justify his hostility towards providing transsexuals access to gender reassignment surgery.  

I've taken McHugh's previous writings apart in Debunking Dr. Paul McHugh, but this is a new column, and he's tried to throw a few new angles in.  Unlike most anti-trans writers, McHugh tries to actually use some objective research to support his position ... like a lot of such people, he tries to twist it to suit his ends.

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

For all that many in the Trans* community direct their ire at CAMH's Dr. Zucker, they should be at least somewhat thankful that it was Zucker not McHugh sitting on the DSM V Gender Issues committee.  I fear the results of McHugh being on that board would have been far, far worse.

It's Not Just About Trust

One of my news feeds dropped the following article this morning:  "Gender Transition isn't a Whim, so Why the Mistrust?".

After reading through it, the article is more or less the standard "I know I need this surgery, so why can't I get it on demand?" argument.

To a certain extent, I am sympathetic to this.  People who are transsexual usually know from an incredibly early age that they are, and what they need.  This is beyond question in my mind.

The notion of informed consent is pervasive in Western Medicine, and in general terms it works fairly well.  But, informed consent is a point solution to a specific problem.  Informed consent does tackle the understanding of what the effects of a specific form of medical intervention are.  Usually in terms of physiological issues, potential complications and so on.

When it comes to gender transitions, trans patients are often inappropriately held to higher account when compared to people opting for other kinds of medical care. Standards of care are effectively constructed on the assumption that trans patients are less able to provide informed consent. This is a serious problem. Beneath it lies the wider distrust society still has in why people want to transition and in whether they know their own mind. 

Typically, the standard for surgeries — from cosmetic plastic surgery to vasectomy, tubal ligation, and abortion — is simply informed consent. A doctor or surgeon talks with the patient and explains what they expect to happen, along with all of the risks and benefits and the relative likelihoods of them happening. This process also involves explaining available alternatives and the risks or benefits of doing nothing. After the patient confirms that they understand all of this, the doctor is said to have received informed consent for the procedure. 

A patient is required to be competent to make this decision and if they are unable to understand for some reason – if they are too young for example – another person, such as a parent, may be required to step in.

It took me a few minutes to figure out what bugs me about this claim.  The issue is not merely that it is a case of "informed consent" for Gender Reassignment Surgery (GRS), but rather that gender transition is a complex process that encompasses a wide range of actions and treatments.

Any one step of transition requires a degree of informed consent.  For example, starting cross-sex hormone treatment requires that the doctor and patient have a clear, coherent discussion of the effects of hormones - both short and long term, as well as possible side effects.  However, taking hormones is merely a facilitating step in the process of transitioning across genders.  One step of many that a patient is ultimately undertaking.

Gender transition is not one step.  Hormones and GRS are the tangible markers that most people can grasp.  What is much harder to understand is the long term process of social transition.  For some, it is an easy, almost seamless process, for others it can be much more difficult to make the adaptations they desire.

And it’s the gatekeeper model of healthcare in the US, UK and many other jurisdictions, typically involving a psychologist of psychiatrist, that creates an additional barrier. Although some (private) clinics in the US have finally begun to adopt a model where all that’s required for a patient to begin hormone therapy is their informed consent, genital surgery still requires psychologist or psychiatrist approval. Many surgeons require two letters — as set out in WPATH’s standards — at least one of which must be from a psychologist or psychiatrist with a PhD. 

In reality, the requirements for trans patients are even more stringent: in order to be permitted genital surgery – even if the patient elects to pay for it – patients have to demonstrate that they’ve been living in their transitioned gender role for a minimum of a year.

 I can appreciate the perception that there is a "gatekeeper" mentality in some areas.  Let's face it, your average GP or Endocrinologist simply doesn't have a lot of training in dealing with cross-gender patients, and as a result may feel profoundly uncomfortable providing treatment without the input of a psychologist who specializes in such matters.

Western Medicine has become very "siloed" in the last fifty years or so.  Most GPs don't have the tools to make specialized diagnosis and refer patients to specialists all the time.  Specialists are often so focused in their own domain that they really do not feel comfortable making assessments outside of that domain.

To some extent this can be addressed by training, but it doesn't necessarily resolve the ethical and practice guidelines considerations that all of these professionals are bound by.  It would be very nice indeed if there was more uniformity in this regard, but there isn't.  Even more unfortunate is that in some localities, physicians have been known to turn trans patients away on the basis of personal beliefs on the matter rather than practical medical guidance.

Is it "gatekeeping" for a GP to say that they want an assessment from a psychologist before providing hormone therapy?  If we are talking about a situation where the psychologist is trying to make the availability of the referral letter contingent on a long term therapeutic relationship, one might be a little bit concerned.

However, the WPATH SOC v7 addresses this quite explicitly:

The SOC do not recommend a minimum number of psychotherapy sessions prior to hormone therapy or surgery. The reasons for this are multifaceted (Lev, 2009). First, a minimum number of sessions tends to be construed as a hurdle, which discourages the genuine opportunity for personal growth. Second, mental health professionals can offer important support to clients throughout all phases of exploration of gender identity, gender expression, and possible transition – not just prior to any possible medical interventions. Third, clients differ in their abilities to attain similar goals in a specified time period.  

Further, the SOC sets out fairly clearly the basic criteria for GRS referral:

Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients: 

1.  Persistent, well documented gender dysphoria; 

2.  Capacity to make a fully informed decision and to consent for treatment; 

3.  Age of majority in a given country; 

4.  If significant medical or mental health concerns are present, they must be well controlled; 

5.  12 continuous months of hormone therapy as appropriate to the patient’s gender goals (un- less the patient has a medical contraindication or is otherwise unable or unwilling to take hormones). 

6.  12 continuous months of living in a gender role that is congruent with their gender identity;
Although not an explicit criterion, it is recommended that these patients also have regular visits with a mental health or other medical professional. 

Rationale for a preoperative, 12-month experience of living in an identity-congruent gender role: 

The criterion noted above for some types of genital surgeries – i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity – is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role, before undergoing irreversible surgery. As noted in section VII, the social aspects of changing one’s gender role are usually challenging – often more so than the physical aspects. Changing gender role can have profound personal and social consequences, and the decision to do so should include an awareness of what the familial, interpersonal, educational, vocational, economic, and legal challenges are likely to be, so that people can function successfully in their gender role. Support from a qualified mental health professional and from peers can be invaluable in ensuring a successful gender role adaptation (Bockting, 2008). 

The duration of 12 months allows for a range of different life experiences and events that may occur throughout the year (e.g., family events, holidays, vacations, season-specific work or school experiences). During this time, patients should present consistently, on a day-to-day basis and across all settings of life, in their desired gender role. This includes coming out to partners, family, friends, and community members (e.g., at school, work, other settings). 

Health professionals should clearly document a patient’s experience in the gender role in the medical chart, including the start date of living full time for those who are preparing for genital surgery. In some situations, if needed, health professionals may request verification that this criterion has been fulfilled: They may communicate with individuals who have related to the patient in an identity-congruent gender role, or request documentation of a legal name and/or gender marker change, if applicable. *Emphasis Added

Ms. McKinnon goes on to critique these requirements as follows:

More explicitly, such policies aim to force patients to experience and adjust to life in their transitioned gender role before providing treatment. The implied rationale, then, is that without living in your transitioned gender role, which may include changing your name or the style of clothes you wear, you can’t really know whether you want the surgery – and therefore can’t really provide informed consent. This “real life test”, as it very recently used to be called, is for the patient’s own good; if someone lived through the proscribed period of time and still wanted surgery, then the gatekeepers could be confident that surgery would be in the patient’s best interest. 

This is deeply problematic, though. This isn’t an informed consent model of healthcare, which is the universal model (in western cultures) for everything except healthcare for transgender people.

Here is where I beg to differ with Ms. McKinnon's assessment of the situation.  She seems to have conflated GRS with gender transition.  The two are NOT the same thing, although they are closely related to each other.  The claim being made is fundamentally that as long as the patient is able to give "informed consent" to GRS, they should be able to have access to it.

Superficially, this seems almost reasonable.  However, there are two enormous "buts" that must be discussed here.

First, unlike every other surgical procedure out there, GRS unequivocally changes the patient's status in many different aspects of their life, not merely in the relative privacy of our bedrooms.  As part of a broader picture of gender transition, it also affects the patient's social context and status, friendships, workplace and goodness knows what else.  Informed consent for GRS has to account for these realities somehow.

Second, we know that there are those who attempt to gain access to GRS who either are unsuitable candidates, or have not yet adapted to their chosen gender role in society.  Whether we are talking about characters like Walt Heyer (how he ever got approval for GRS is beyond me, but that was the early 1980s, a different era), or the person who early in their journey decides that they desperately need surgery *now* (I've seen it, and I personally have talked more than one such person out of their tree - at least half of them backed away from transition after that, and I respect them for having the strength and wisdom to recognize when to step away from the precipice)

One of the things that makes gender transition quite different from other conditions that doctors deal with is that it lacks clear diagnostic criteria that they can examine objectively.  In fact, there are no physiological symptoms that they can examine directly.  Is it unreasonable that the surgeons insist upon an objective third party assessment?

We also cannot ignore the political dimension of those who choose GRS and then discover that they made an awful mistake.  People like Mr. Heyer run around spouting a pack of lies a mile deep about about GRS, and ultimately make it more difficult for the rest of the trans* community to access the treatment they need.  This cannot be ignored, nor can we ignore the consequences for both transsexuals seeking treatment as well as the practitioners that they rely on.

But to argue that this contravenes the notion of "informed consent" is to assume that "informed consent" is a one way street.  It is not.  Informed Consent merely means that the practitioner has discussed with you the treatment that is proposed and its consequences.  In general, it starts from the presupposition that the practitioner has performed sufficient diagnostic assessment to be confident that this treatment will address the diagnosed condition, something which few surgeons will feel that they have the appropriate diagnostic skills for in the case of GRS.

What has changed is that although a psychologist's assessment is needed for a surgery referral, there is no explicit requirement for a long term therapeutic relationship.  (This didn't really exist in the previous SOC, but the current SOC is much clearer about it)

In short, Ms. McKinnon's position is based in large part on a misunderstanding of the nature of the WPATH SOC, and even more troublingly a failure to understand the ethical issues that a surgeon faces in providing GRS.  She tries to draw analogies with other "on demand" surgical options, but fails to acknowledge the unique aspects of gender transition in general.  No other medical process has such a profound impact on the life of the patient.

To proceed with caution has merits for both practitioners and patients in the long run.  A vasectomy can be reversed, a woman who has an abortion has the opportunity to become pregnant again.  gender transition is a process that is far more broad in its impact than just the patient.  Their social context changes, the people around the patient are very directly impacted, and so on.  "Undoing" all of that is difficult to say the least - at least as difficult as transition itself, and then there is the physical impossibility of "undoing" GRS.  To look at one part of the process - surgery - apart from all of the other aspects involved is incredibly short-sighted.

It may be frustrating, but a successful gender transition really does require many experts to contribute their expertise.  I would love to argue in favour of more open access, but the potential for serious harm to happen to someone whose motives for transition are unclear or they are ill-prepared for it is far greater than the implications of having a few cross checks in the system.  The world needs fewer Walt Heyers, not more.

How The National Review's Williamson Gets It Wrong On Laverne Cox

Kevin D. Williamson is suddenly an expert on the topic of transgender and transsexual people it seems.  Or at least, he has appointed himself as an expert.

Titled "Laverne Cox is not a Woman", Williamson's column is a pretty basic attack on transsexual people and the issue of being cross-gender identified.  In its most fundamental sense, he is trying to erase the very narrative of transsexuals (and other transgender identified people):

The infinite malleability of the postmodern idea of “gender,” as opposed to the stubborn concreteness of sex, is precisely the reason the concept was invented. For all of the high-academic theory attached to the question, it is simply a mystical exercise in rearranging words to rearrange reality. Facebook now has a few score options for describing one’s gender or sex, and no doubt they will soon match the number of names for the Almighty in one of the old mystery cults.

Apparently the evolving language of an emerging field of study is just a bunch of academics trying to evade reality ... at least for Williamson.  Unfortunately for Williamson, it is not mere "rearranging words to rearrange reality" so much as seeking language that accurately depicts reality.  Had Mr. Williamson looked beyond his assumptions, he would have discovered that much of the modern language around cross-gender identity started with the "Benjamin Scale".  At this point in time, it became necessary to describe more than cross-dressing, and Benjamin made what seemed a reasonable approach at the time.  Since then, the understanding and language related to the broad notion of cross-gender identity has grown enormously, to the point of being daunting to those who do not spend significant time working with it.

It is not difficult to see why Williamson and his allies try to claim that this is just linguistic voodoo.  The semantics are complicated, and understanding the subtle distinctions that need to be grasped to fully appreciate the language involved is no small task.  Far easier to dismiss it as "irrelevant" or "magic" than to examine it critically.

Regardless of the question of whether he has had his genitals amputated, Cox is not a woman, but an effigy of a woman. Sex is a biological reality, and it is not subordinate to subjective impressions, no matter how intense those impressions are, how sincerely they are held, or how painful they make facing the biological facts of life. No hormone injection or surgical mutilation is sufficient to change that. 

Ah yes ... born with a penis = man, born with a vagina = woman ... and old and somewhat brain damaged way to look at these matters.  Unfortunately for Williamson, there is a distance to be covered between the social notions of "man" and "woman" - concepts which are mostly social, and the physiological sex notions of "male" and "female".  Physiological sex is fundamentally about the shape of the body, "man" and "woman" are primarily social constructs with roots in physiological sex.

DF Swaab 2007 states quite clearly the following:

 As sexual differentiation of the genitals takes places in the first 2 months of pregnancy, and sexual differentiation of the brain starts during the second half of pregnancy, these two processes may be influenced independently of each other, resulting in transsexuality. This also means that in the case of an ambiguous gender at birth, the degree of masculinization of the genitals may not reflect the same degree of masculinization of the brain. Differences in brain structures and brain functions have been found that are related to sexual orientation and gender. 

Research findings like this poke significant holes in the "has a penis = man" logic of people like Williamson. As many transsexuals can attest to, you can be born with a penis and never feel the least bit like a man.

Returning to Williamson's rather naive attack on transsexuals, we find a few more gems of logic:

Genital amputation and mutilation is the extreme expression of the phenomenon, but it is hardly outside the mainstream of contemporary medical practice. The trans self-conception, if the autobiographical literature is any guide, is partly a feeling that one should be living one’s life as a member of the opposite sex and partly a delusion that one is in fact a member of the opposite sex at some level of reality that transcends the biological facts in question. There are many possible therapeutic responses to that condition, but the offer to amputate healthy organs in the service of a delusional tendency is the moral equivalent of meeting a man who believes he is Jesus and inquiring as to whether his insurance plan covers crucifixion.

Oh yes, let's talk for a moment or two about the language of "delusion", shall we?  The DSM IV (and the drafts of the DSM V text I have reviewed) all contain a very clear statement regarding the issue of psychological delusion in transsexuals.  Quite specifically, there is a clause in there that recognizes that a transsexual is usually perfectly aware of the distance between their physical and psychological realities.  This isn't a delusion.

Gender Reassingment Surgery (GRS) is an imperfect solution, but at least for MtF transsexuals it enables a degree of physical congruence between self-image and body that otherwise is impossible to achieve.  Like many people, Mr. Williamson seems to view this is "mutilation".   Most transsexuals would disagree with good reason.

The question of the status of gay people interacts with politics to the extent that it in some cases challenges existing family law, but homosexual acts as such seem to me a matter that is obviously, and almost by definition, private. The mass delusion that we are inculcating on the question of transgendered people is a different sort of matter, to the extent that it would impose on society at large an obligation — possibly a legal obligation under civil-rights law, one that already is emerging — to treat delusion as fact, or at the very least to agree to make subjective impressions superordinate to biological fact in matters both public and private. 

As a matter of government, I have little or no desire to police how Cox or any other man or woman conducts his or her personal life. 

What Williamson is overlooking is the fact that the history of both sexual and gender minority communities is that they are traditionally oppressed by the state in a very explicitly.  It's all very well that Williamson doesn't wish to regulate how Laverne Cox lives her life.  What he is quietly ignoring is that the coercive power of the state has been used to suppress LGBT people, and gave rise to the hostility and discrimination that they experience.  This simple fact means that by definition, the matter of rights and non-discrimination requires active engagement on the part of the state to rectify past and present wrongs.

But having a culture organized around the elevation of unreality over reality in the service of Eros, who is a sometimes savage god, is not only irrational but antirational.

Here we have the last trope possible - namely that it's all about sex.  Williamson couldn't be more wrong if he tried.  Sure, most people want an active and satisfying sex life.  Some people achieve that, some do not.  While GRS certainly can play a significant role in helping achieve that goal, it is seldom the primary reason for it.  What Williamson appears to completely misunderstand is that bodily congruence is at the top of the list for most transsexuals.

I don't know what Williamson's criteria for "womanhood" are.  He doesn't really tell us, but I would suspect that a great many natal females would not meet his standards, whatever they might be.

On RuPaul And The Use Of Language

I've seriously tried to stay away from the fracas that has developed around RuPaul's use of the word "Tranny" (and a couple of other terms which I think are both denigrating and offensive to transitioning transsexuals that I will not repeat here because they are straight out of the fantasy world of pornography).

However, after his latest outburst, I cannot remain silent on the subject any longer.

RuPaul is giving the entire drag community a bad name as far as the rest of the Trans* community is concerned.

Here's why.  Drag is seen as performance art first and foremost.  In that context, I can respect the fact that the use of certain slang in that community is going to be over the top.  Heck, in the context of his show, I don't even get terribly upset about it.

The problem is that the term "tranny" is seen by many who are transition bound as an epithet.  Most MtF transsexuals view themselves as women, or possibly "trans-women" for those who acknowledge their past.  Terms like "tranny" come out of the pornography world and promote objectification of trans women and their bodies.

Women have fought for years against being treated as objects.  Transsexual women fight a dual battle on this front.  Not only do they face the casual objectification that most women experience in their daily lives, but they also find themselves subjected to a great deal of sexual objectification as a result of their personal history.  It should come as no surprise that the Trans* women are up in arms over RuPaul's repeated outbursts.

The irritation arises from a perceived disrespect.  The community has been clear many times in the past that it does not like the language of "Tranny" (or other words), and RuPaul in particular keeps on using it in very public contexts.  Perhaps in the land of Drag the language used is perfectly acceptable.  That doesn't mean in a public context the terms are understood as having the same meaning or that they don't apply to other parts of the "transgender community".

RuPaul's "take a chill pill" response to the trans* community is unfortunately the wrong response.  It just serves to inflame tensions.  I've seen a lot of trans women point out that Drag Queens don't live it 24/7, and therefore don't have any right to use language that is so offensive to them.  To some degree they are right - RuPaul seems to have lost sight of the fact that his language is reflecting on more than just his show.

I'm not at all sure how RuPaul would react to the use of the racist "n-word" by a bunch of white people, or the "f-word" by straight people.  There are certainly parallels to be considered.  Out of respect, people of caucasian descent don't use the "n-word", especially not in public settings.  It would be nice if RuPaul would apply the same rule to his own choice of language where it overlaps with other populations in the trans* community who object to it.

[Update 28/5/14]
... and the poison spills forth from the participants of RuPaul's show.
[/Update]

No, Transition Does Not Absolve You Of Your Past

I'm sure that the far right is going to use this story in the war currently being conducted on transgender rights in both Canada and the United States.  

Transgender Defense: 'Donna' Says 'Doug' Is the Spokane Serial Killer

In fact, LifeSite has already picked up on the story:

Transsexual accused of serial killing: I didn’t kill those women because I’m a new person

According to the ABC News story, Donna Perry is trying to claim that she cannot be held accountable for murders that she committed prior to undergoing gender reassignment surgery.

When detectives interviewed Perry and asked why the murders had stopped, she replied, "Douglas didn't stop, Donna stopped it," according to the affidavit. 

... 

The accused's reported defense that it was not Donna Perry but Douglas Perry who killed the women is headline-grabbing, but not necessarily a true reflection of how transgender people view their nonconforming identity, according to mental health experts.

I have enormous problems with this as any kind of defence in a court, and I would hope that her lawyers would advise against it as well.  Simply put, although it is hardly uncommon for transsexuals to talk about their pre-transition lives in a somewhat dissociated manner, transition does not produce a "whole new person".  More realistically, one is the sum of their experiences before and after transition.  Transition is an opportunity for enormous personal growth, but it hardly absolves one of what happened before transition.

"For some people, it's a metaphor: 'I was a different person before I came out,'" said Dr. Jack Drescher, a New York City psychiatrist who sat on the work group on sexual and gender identity disorders contained in the DSM-5 -- the latest edition of the Diagnostic and Statistical Manual. 

"It's a certain way that they use the metaphor when transitioning for those who were very unhappy before and now are happy," he said. "But it's different when a person makes a claim that somehow they have no linkage to the person they used to be –- that would be more of a disturbed presentation." 

Having what is now called gender dysphoria in the DSM-5, does not necessarily mean that a person has impaired judgement, which is often a legal defense, according to Drescher. 

"It's wrong to generalize from this person's life – it's not typical of the transgender experience," said Drescher, who does not know Perry and is not connected to the case. 

Dr. Drescher makes some very clear points, and his second statement is in fact what I thought when I first read the article.  If Ms. Perry in fact thinks of "Doug" as a distinct entity quite separate from herself today, there could well be a much more serious psychological issue over and above Gender Dysphoria.

Regardless, I would very surprised if any court would accept core of the argument that is being made by Ms. Perry.  At its core, it implies that because she underwent gender transition that she cannot be held accountable for criminal acts which occurred before transition.

My concern is twofold.

First, I do not believe that Gender Dysphoria should be seen as sufficiently debilitating to result in a "not criminally responsible" finding.  It is a serious condition, to be sure, but I would find it extremely difficult to swallow the notion that someone who is transsexual is not capable of understanding the difference between right and wrong in making their day to day decisions.

Second, such a finding would effectively undo any equality rights gains that have been made in the last thirty years.  While I have no doubt that the writers at LifeSite News would be positively ecstatic with such an outcome, the consequences for the real lives of a lot of people would be devastating.

Most likely, I expect Ms. Perry will find that she is found guilty of murder, and locked away for the remainder of her life for actions done long before she transitioned.

Wente Is Getting It Wrong ... Again

I suppose it should come as little or no surprise that Margaret Wente is getting things wrong again.  This time, she is expounding on the treatment of transgender children.

Suddenly transgender kids are everywhere – in the news, on Dr. Phil and in your neighbourhood. School boards have developed detailed transgender policies. Clinics to treat transgender kids have sprung up. A condition that used to be vanishingly rare, perhaps one in 10,000 children or less, now seems common. In a random sampling of 6th- to 8th-graders in San Francisco, kids were asked if they identified as male, female or transgendered – 1.3 per cent checked off the transgendered box. 

She concludes with:

It’s a mark of social progress that we are increasingly willing to accept people on their terms, for who they are. But maybe we’re manufacturing more problems than we’re solving. If we really want to help people, we should remember the old rule: First, do no harm. 

Through the entire article, she relies on two authorities - Dr. Kenneth Zucker and Alice Dreger.   Zucker, along with his colleague at CAMH Ray Blanchard, have long been seen by the transgender community as deeply problematic - for good reason.

Ken Zucker is a psychologist at the Clarke Institute (aka "Jurassic Clarke") in Toronto. Zucker is famous for forcing gender-variant children into reparative therapy to conform to his expectations for male and female behavior in children. He considers transsexual women a "bad outcome" for gay men. 

Zucker is a darling of the "ex-gay" movement because of his work "curing" gender-variant children. Here is a piece featuring his work via ex-gay group NARTH (National Association for Research & Therapy of Homosexuals): 

http://www.narth.com/docs/gid.html 

Zucker promotes his NARTH-like notions of reparative therapy for kids with gender variance, reviewed here on another ex-gay site: 

http://www.leaderu.com/orgs/narth/childhood.html

We already know that so-called "reparative therapy" doesn't work for homosexuality, what on earth makes Zucker, or anyone else, think that it has any validity for transgender people.

As for Ms. Dreger, anyone silly enough to get into bed with J. Michael Bailey and defend the atrocious work that he wrote called "The Man Who Would Be Queen" has a serious credibility problem in the first place.

Quoting from Ms. Dreger, Wente draws the following:

Here’s more unwelcome news from Ms. Dreger. A child’s gender issue may merely be a symptom of other family problems. “The dirty little secret is that many of these families have big dysfunctional issues. When you get the clinicians over a beer, they’ll tell you the truth. A lot of the parents aren’t well in terms of their mental health. They think that once the child transitions, all their problems will magically go away, but that’s not really where the stress is located.” Clinicians won’t say these things publicly, she says, because they don’t want to sound as if they’re blaming gender problems on screwed-up families. 

Can we dredge any more old tropes?  We used to blame the parents for their kids being gay, now we're replaying that same ridiculous script when someone's child turns out to be transgender?  Give me a break.  If Ms. Wente had bothered to even do a little bit more research, she would have found that Ms. Dreger is grossly distorting the picture.

The WPATH SOC V7 provides the following guidance to mental health professionals:

Provide family counseling and support- ive psychotherapy to assist children and adolescents with exploring their gender identity, alleviating distress related to their gender dysphoria, and ameliorating any other psychosocial difficulties. 

This is extremely important when examining what Dreger is saying.  Namely that she is implying that the treatment community has a mass conspiracy afoot to deny that there are "other problems" that are at the root of being transgender.  If that was the case, the WPATH SOC would not contain language like this.  Dreger's claims are very similar to those of Walt Heyer - whose misadventures negate his own claims of misdeeds and malice on the part of the treatment community.

Wente's argument also draws the following from Dreger:

For some people, including some adolescents, transgender treatment is lifesaving. But these treatments are neither simple nor benign. They may, among other things, retard maturation, suppress your growth or render you sterile. And in the end, medical science cannot create a body that makes you forget you were born the other sex. “Some kids need it, but for the kids who don’t, it’s dangerous,” she says. “All else being equal, it’s better to avoid long-term hormone therapy and major surgery that removes a lot of tissue.” 

Disturbingly, data on long-term outcomes for transgender kids are scarce. No one is tracking the evidence on puberty-blocking intervention either. “We are doing major interventions and we have shockingly little idea what the outcomes are,” Ms. Dreger says. You get the sense that what we have is not so much a rational approach to a psychosocial issue as a radical ideological experiment. 

Let's see ... the percentage of the population that is transgender is tiny to begin with.  It's going to be an even smaller percentage who are going to be able and willing to express those desires before they reach puberty.  Ironically, most transsexuals know that they are trans long before the age of puberty.  If the option not to go through "the wrong puberty" exists, dear god, but it would be a blessing for so many.

Dreger's claim that there is a lack of long term consequences data available is also highly questionable.  Given the fact that Dr. Spack has been been running his clinic in Boston since 2007, the criticism about "long term consequences" is debatable.  The fact is that just about every transsexual who has transitioned wishes that they had done so earlier than they did.  We already know the consequences of insisting that transsexuals go through puberty the wrong way, and then try to undo it through transition as adults - the psychological trauma is no small thing to deal with, and the cost of living life in the wrong body is impossible to calculate.

Quoting Zucker:

Gender dysphoria (formerly known as gender identity disorder) means being at odds with your biological sex. It’s not the same as being born with ambivalent genitalia, or being gay. The popular shorthand is “being born in the wrong body,” although that formulation probably does more harm than good. Sex-reassignment treatment is appropriate for some (although by no means all) adults who are unhappy with their gender identity, and some go on to live significantly happier lives. 

But for kids, especially younger ones, the issue is much more problematic. Gender confusion is often temporary. About three-quarters of little kids who have issues with their gender – boys who want to be princesses, girls who throw their dresses in the garbage – will be comfortable with it by adolescence, according to Dr. Zucker. (Many of them will grow up to be gay or bi.) Gender confusion can also be a handy label for whatever ails a child (or her family). That’s why Dr. Zucker takes a watch-and-wait approach. He even advises parents of princessy six-year-olds to say, “You’re not a girl. You’re a boy.” 

The point that needs to be made (again), is that the WPATH SOC is similarly clear about caution regarding the introduction of physical interventions:

Before any physical interventions are consid- ered for adolescents, extensive exploration of psychological, family, and social issues should be undertaken, as outlined above. The duration of this exploration may vary considerably de- pending on the complexity of the situation.  ...

In order for adolescents to receive puberty- suppressing hormones, the following minimum criteria must be met: 

1. The adolescent has demonstrated a long- lasting and intense pattern of gender non- conformity or gender dysphoria (whether suppressed or expressed);
2. Gender dysphoria emerged or worsened with the onset of puberty;
3. Any coexisting psychological, medical, or social problems that could interfere with treatment (e.g., that may compromise treatment adherence) have been addressed, such that the adolescent’s situation and functioning are stable enough to start treatment;
4. The adolescent has given informed consent and, particularly when the adolescent has not reached the age of medical consent, the parents or other caretakers or guardians have consented to the treatment and are involved in supporting the adolescent throughout the treatment process. 

These are not trivial claims, and an ethical practitioner is going to be very careful in making this kind of assessment and recommendation ... and that is for a reversible intervention.

Here is where Ms. Wente makes me quite annoyed.  Her article makes it sound like there is a sudden epidemic of children who are transgender springing up, and that these children are being "exploited" by greedy treatment providers.

Of course, she engages with Zucker and Dreger, two people who are going to validate her assumptions.  Does she expand her research to include Dr. Spack?  No.  Does she even take the time to review the WPATH SOC?  No.

Ms. Wente should be ashamed of doing such sloppy research, and the Globe and Mail should be embarrassed for publishing such tripe.

Distort Things Much?

Over at his blog (where he has conveniently turned off comments), we find Walt Heyer madly scribing away, and getting it horribly wrong.

He refers to three cases of what he supposes are gender transition regret:

1) Like the physician who wrote me. He became a “trans woman.” Yes, a physician! Even after following all the standards of care, he found regret and detransitioned back to his male birth gender. This physician looks back and now says, “If I could only go back to the day before my surgery in March of 2005--I would run from that surgeon’s knife.” Sadly, the approval process for surgery does nothing to reduce such stories.

2) Like the ABC news guy who wanted everyone to accept him as a transgender woman. Don Ennis, an ABC News editor, suffered a gender identity crisis, switched his gender twice in a three-month period, and posted a workplace memo attributing his actions to amnesia. Don became Dawn. Amnesia or multiple personality disorder? Anyway this is like many of the regret letters I get from guys who were completely convinced they were women trapped in a men’s bodies only to discover later they had some psychological problems. http://www.nypost.com/p/news/national/guy_again_eKq3Jw6LjgsjpBdmZklrtM

3) Like the NFL cheerleader, Texas native Philip Porter, who made the decision to transition back to his male birth gender after a whopping 32 years living as a transgender woman.

“I was born male, and always felt more female than male as a child growing up, to the point of before I could talk, [I thought] ‘I should be over there with the girls in dresses. After 34 years on female hormones, Philip started having discomfort with “hot flashes” so he discontinued using them. “I just said ‘Ok, I’ll stop taking these for awhile but it’s not going to change back after 34 years of taking them.’”

“And after that, it just started happening,” he continued. “After about 6 months to 9 months being off of them, ‘you know, you never gave yourself a chance to sort of live as a male. What would that be like?’ And it kind of was something in my mind that started as just a little thought that kind of like snowballed. And you know, I mean that’s just kind of how it happened.

It was just that simple, even after 32 years. So what is a “real” transgender? Is 32 years not long enough? 

His first case, I am somewhat suspicious of.  Heyer keeps on referencing this person, but they appear to have no public profile whatsoever.  The story cannot be verified independently, and given Mr. Heyer's propensity in the past for fabrication, and distortion, I am deeply suspicious of its veracity as presented on Heyer's blog.

The second case Mr. Heyer refers to actually shows us a case of the WPATH SOC working in the manner described.  The story of Don Ennis has been fairly widely publicized.  Exactly what motivated him to step back from transition is unclear to me.  In any case, he attempted transition and stepped away from it after a fairly brief time period.  This is not particularly unusual, nor does it represent any kind of failure of the treatment protocol itself.

As for Philip Porter, his story is unusual.  I am not at all sure that his choice to detransition after 30 years tells us anything other than people can, and do change.  Nothing in his story speaks of "regretting" his transition or time as a woman, so it seems more than a little specious to claim that as some kind of proof that the SOC as a treatment protocol is a failure.

Detransitions are now becoming BIG BUSINESS. The Sava Perovic Foundation website reports that worldwide more than 1,500 persons who got sex change surgery later decided they had made a mistake.
According to a doctor I know, Dr. Sava Perovic was the greatest urogenital surgeon of our time treating probably every anomaly of the reproductive organs and the urinary system that you can think of. Dr. Perovic was also responsible for teaching SRS to surgeons in Thailand. His foundation is now offering reversal surgery for regretters. 

Mr. Heyer needs to do a much more careful reading of the Sava Perovic Foundation's website.  Yes, it does mention GRS reversal procedures - but it is also abundantly clear that those surgeries are provided based on the same kind of psychological assessment that the WPATH SOC requires in the first place.  In short, the WPATH SOC exists for a reason, and their surgeons won't provide surgery for someone seeking GRS (or reversal of GRS) without appropriate psychological assessments.  I think it is important (if not vital) to note that the Sava Perovic Foundation also provides GRS services - and is rightly quite insistent that the WPATH SOC be followed.

There are only a limited number of ways that the WPATH SOC will fail to protect a patient - and most of them are the direct result of the patient attempting to "game" the system instead of being brutally honest with themselves.  I would be willing to bet that the vast majority of those "inappropriate" GRS procedures are the direct result of the patient managing to lie their way through the evaluation process.  As I have noted before, Mr. Heyer admits in his own autobiography that he lied routinely in his pursuit of GRS.  A reality that calls into question the accusations he makes of the treatment community.

Wow, Walt - Generalize Much?

If the latest utterances from Walt Heyer were the first you had ever heard from him, you could easily be forgiven for believing that the man had never had anything to do with the transgender community.  

Women—Simply Men with no Snoopy 

The real war on women today is being waged on the female gender by men who remove their tallywacker (Snoopy) and declare they are full-fledged women. 

These people, transgenders who are just men with no Snoopy, can use your restrooms and change the gender designation on their birth records and other ID to female. They’ll show you birth gender females a swinging thing or two by legally proving that you females are the same as men, just with no Snoopy. 

Transgender women, manufactured from men by surgery, have more protections under the law then you pesky women who were born female. 

Depending on what your view of female is, you may see transgender females (i.e., men who removed their tallywacker) as lovable little fuzzballs who need to be protected from the wacko, transphobic, homophobic, bigoted gender normals who were born male and female. 

Perhaps you see transgender women as men who enjoy what looks like childish play gone psycho with dress-up taken to extreme–copious amounts of makeup, flamboyant mannerisms, surgical breasts, facial work and yes, the removal of the old useless trouser snake known as "Snoopy." 

This post was prompted by talking with a woman I know who is outraged that birth gender women do not march by the thousands against lawmakers. She is appalled that a man without a dangling participle is made legally equivalent to a birth female. She feels that laws that protect surgically-produced replicas of women denigrate and ridicule real women and the female gender. 

In effect, the lawmakers are now saying that women are simply men with no Snoopy. Like it or not, it is the sign of our times.   

Walt Heyer

Apparently in Heyer's fevered mind, trans people are now part of the "war on women".  I'm not sure how he arrives at this, since it is conservative Republicans who are busily passing laws that disproportionately affect women for the worse, making reproductive health care all the harder to access, or forcing unwanted invasive procedures on women.

His characterization of transgender people as a whole sounds like something out of a couple of nights spent getting drunk in a drag bar, on par with the research that Bailey did for his book a few years ago.  It's funny how Heyer comes up with all sorts of generalizations about trans people, and yet I would wager he wouldn't be able to identify half of the trans people he interacts with on a daily basis.  

If recognizing women of transsexual history as women is somehow "denigrating" or "ridiculing" natal women, I'd love to hear just how that works.  I have yet to meet a transsexual whose life and experience could be argued as "denigrating" of women.  The only people that make such arguments are usually Radical Feminists and ultra-conservative religious demagogues who seem to think that womanhood (or manhood) are defined by chromosomes.  I have never seen a coherent argument which supports the contention that a MtF transsexual is somehow co-opting the female experience.

If Heyer was to actually think things through, what he would realize is that in many respects the places where law has engaged with the language of gender, it is no longer useful to do so.  Does it matter if your driver's license stipulates gender?  Probably not.  Last I checked, women can be just as lead-footed as men, and the speeding ticket is the same either way.  Outside of certain statistical applications, gender is utterly irrelevant.

Of course, in areas such as health care, women have specific needs that must be met that a male bodied person will never need.  I know of no transsexuals who stand in opposition to proper medical care for women.

Frankly, I'm beginning to suspect that Heyer is just jealous of the successful transitions that others have made simply because of his own failings.  

Book Review: Sex Change - It's Suicide by Walt Heyer

I have spent the last few days wading through Walt Heyer's latest self-publish book entitled "Sex Change - It's Suicide".

I'd like to say that it brings something new to the table.  It doesn't.

Frankly, this book is a mess.  It consists largely of the author pounding on the table and blaming the high suicide ideation/attempt rate identified in the 2010 NTEC study on the treatment community.

He doesn't really make any new arguments relative to what he argued in "Paper Genders".

Heyer has tried to make the case that the current treatment for transsexuals is horribly flawed.  This is largely predicated on his own disastrous attempt to transition in the early 1980s.  More or less, his claim is that because he transitioned while suffering from an undiagnosed dissociative disorder that everybody else who attempts transition is suffering from something other than what they think.

Unfortunately, Heyer makes enormous leaps of inference and asserts his position as fact without substantiating his position.  The majority of his evidence is anecdotal, or it is made in reference to deeply flawed research which has been largely debunked.

Heyer is no friend of the transgender community.  Although he speaks the words of compassion and advocacy for appropriate treatment, his underlying agenda is to prevent transgender people from having access to the treatment programs that are known to be effective.

[Update 16/08/13]
Heyer seems to have pulled the original Sex Change - It's Suicide title, and re-released under the title "Gender Lies and Suicide"

The summary of the book appears to be more or less identical to "Sex Change - It's Suicide" version, so I doubt there's anything particularly new other than a change of title.
[/Update]

[More after the jump]

Catholic.org Spouts Off On Transgender Issues

I've tripped over the website "catholic.org" a couple of times in the past.  Generally, I haven't paid them much attention because they seem to be slightly more off their rocker than LifeSiteNews.

However, they posted a particularly vile article today entitled "Gender Is Gift:  The Dangers Of The Gender Identity Movement Must Be Exposed".

Part I:  Who Is CatholicOnline.org?

The first thing I did was try to find out who, or what, is behind the website.  A quick whois dump was quite uninformative:

Domain ID:D129277-LROR

Domain Name:CATHOLIC.ORG

Created On:16-Nov-1994 05:00:00 UTC

Last Updated On:16-Nov-2012 18:39:42 UTC

Expiration Date:15-Nov-2015 05:00:00 UTC

Sponsoring Registrar:Network Solutions, LLC (R63-LROR)

Status:CLIENT TRANSFER PROHIBITED

Registrant ID:46032708-NSIV

Registrant Name:Catholic Online, LLC

Registrant Organization:Catholic Online, LLC

Registrant Street1:ATTN insert domain name here

Registrant Street2:care of Network Solutions

Registrant Street3:

Registrant City:Drums

Registrant State/Province:PA

Registrant Postal Code:18222

Registrant Country:US

Registrant Phone:+1.5707088780

Registrant Phone Ext.:

Registrant FAX:

Registrant FAX Ext.:

Registrant Email:ry62y8nt8zg@networksolutionsprivateregistration.com

About all it did was show a link to Catholic Online, LLC.  Which frankly tells us very little about who is behind this.  The first, and most important, question in my mind was whether or not this group was somehow affiliated with the Catholic Church itself.  A little bit of digging led me to the California Secretary of State website which has a nice little feature for looking up company names:

Results of search for " CATHOLIC ONLINE " returned 1 entity record.

Entity Number	Date Filed	Status	Entity Name	Agent for Service of Process
201003010162	01/28/2010	ACTIVE	CATHOLIC ONLINE, LLC	MICHAEL L GALLOWAY

It doesn't give much more than that, and I'm not surprised by that.  A little bit of digging around turns up a few articles about Mr. Galloway, but nothing particularly revealing beyond having been embroiled in a number of lawsuits over the years.

What it does tell me is enough to be fairly comfortable that any relationship between Catholic Online, LLC and the Catholic Church itself is arms length, and what is published there is reflective of the company and its ownership and is not directed out of Rome.

Part II:   The Article Itself:  Gender Is Gift:  The Dangers Of The Gender Identity Movement Must Be Exposed

Every single human cell contains chromosomes which identify whether we are male or female. That cannot be changed. It is a given. In fact, it is a gift.

Welcome to the opening line - the standard trope we've heard from various sources in the right wing when arguing against any kind of accommodation for transgender people.  Chromosomes determine sex, and sex determines gender ... or so the argument goes.  Of course, there are a plethora of intersex conditions which call that little bit of nonsense into question.

The Gender Identity Movement insists upon the recognition in the positive law of a newfound right to somehow choose one's gender. They insist upon laws which accommodate, fund, and enforce this newfound right. Those involved in the activist wing of the movement want to compel the rest of society to recognize their vision of a brave new world or face the Police Power of the State. In a culture where freedom is redefined as a right to choose anything and liberty has degenerated into license, the newspeak of the age calls the instrumental use of the body of another sexual freedom. Sadly, the same spirit of the age fails to recognize the integral unity of the human person, body, soul and spirit, and has turned the human body into a machine with parts which the revolutionaries think can simply be interchanged. 

The grammar nazi in me desperately wants to tear this paragraph apart.  It is appallingly poorly structured.

However, there are basically three prongs of attack that they are setting out:

1. That laws which prohibit discrimination against transgender people are somehow "creating" a right which did not exist before.
2. That transgender people, simply by existing in the public sphere, are somehow central to the degeneration of society into licentiousness.
3. That transgenderism is based on the notion of body parts being interchangeable. 

I have yet to fully understand what it is that people have against ensuring that all members of society are freely able to live and contribute equally, free from discrimination and marginalization.  Coming from an allegedly Christian source it is particularly disappointing.  One only has to spend a small amount of time reviewing the history of early Christianity to observe that the modern day church has its roots in a highly persecuted group.  That they should engage in the same kind of persecution today is testament to how far the faith has drifted from its roots.

LGBT people have long been pointed to as an example of society degenerating into licentiousness - mostly based on the mythology there is something inherently immoral about someone whose sexual preferences aren't aligned with the "majority".  Really, this is rooted in little more than social "othering" - a favourite tactic of bullies through the ages.

The last claim fails entirely to address the realities of what it means for someone to be transgender.  First of all, it makes the assumption that gender surgery is somehow a central feature of transition.  It is not.  Second, as with the pithy quote used as an introductory statement, it makes the false assumption that there is a direct relationship between gender and genitals.  Talk to anyone who has walked through a gender transition, and you will find that even if they have had Gender Reassignment Surgery (GRS), that there is an awareness that the physical only defines a limited subset of gendered experience.

Quoting former Pope Benedict XVI's address to the Curia in December 2012, the article's author makes the following claims:

"The profound falsehood of this theory and of the anthropological revolution contained within it is obvious. People dispute the idea that they have a nature, given by their bodily identity, which serves as a defining element of the human being. They deny their nature and decide that it is not something previously given to them, but that they make it for themselves. According to the biblical creation account, being created by God as male and female pertains to the essence of the human creature. This duality is an essential aspect of what being human is all about, as ordained by God." 

"This very duality as something previously given is what is now disputed. The words of the creation account: "male and female he created them" (Gen 1:27) no longer apply. No, what applies now is this: it was not God who created them male and female - hitherto society did this, now we decide for ourselves. Man and woman as created realities, as the nature of the human being, no longer exist. Man calls his nature into question. From now on he is merely spirit and will."

Frankly, I do not expect any Pope to be terribly well versed in the subtleties of human experience when it comes to gender, sexuality and the accompanying social baggage.  My expectations where Benedict XVI (Ratzinger) are concerned are exceedingly low.

Ratzinger misses something that is critical in his analysis. He presupposes that the physical body defines the person entirely.  The one thing that psychology has demonstrated in its relatively short history is that mind and body are not guaranteed to be congruent.

Further, his attempt to interpret Genesis literally falls flat on its face when confronted with actual evidence.  Of particular note is the existence of people who have CAS and other intersex conditions.  These are naturally occurring conditions, and just as much part of "God's Creation" as anything else.  Frankly, the rest of the Genesis story is so riddled with statements that we know to be factually incorrect that it is difficult to take seriously any attempt to read it literally.

These articles reflect where this is headed unless we expose it and oppose it. The operative word in all of this is gender.  Cultural revolutionaries are intent on redefining the word. Then, using the Police Power of the State, they insist that people be guaranteed a right to choose their gender and change their mind at whim. 

Babette Francis mentioned a book in the gender identity movement, "Trans People in Love", co-edited by Katrina Fox, an Australian activist, who "wrote an emotive piece for the Australian Broadcasting Commission recently entitled "Marriage needs redefining." In it she insists that all the "gender boundaries" surrounding marriage must be removed. "A more inclusive option," she begins, "is to allow individuals to get married whatever their sex or gender, including those who identify as having no sex or gender or whose sex may be indeterminate."

Well, duh.  As much as the far right wing likes to continue to insist that the only kind of marriage that is valid is between a man and a woman, countries like Canada who have legalized Same Sex Marriage demonstrate clearly that there is absolutely no basis to the fear mongering that society will collapse as a result.  Further, existing marriage laws in so many places hang transgender and intersex people out to dry.

We also face an increase of what are wrongly referred to as Sex Change or Gender Reassignment surgeries. Though those who suffer from Gender Identity Disorder (GID) deserve empathy, the facts remain; no such surgery can accomplish a change of gender or sexual identity. In effect, they mutilate the body and destroy the bodily integrity of the person. 

Every single human cell contains chromosomes which identify whether we are male or female. That cannot be changed. It is a given. In fact, it is a gift.

As previously noted, chromosomes and DNA are far from the entire story when it comes to gender.  Even if you take the line that chromosomes = sex, you run smack into having to explain a variety of intersex conditions where chromosomes clearly do not equal sex.  I'm not at all certain that such simplistic aphorisms are ever going to be meaningful.

Most transsexuals will tell you that if their "birth sex" was a gift, it was given by someone with a particularly nasty sense of humour.

Removal of genitals and attachment of artificially constructed ones which are absolutely incapable of ovulation or conception, in the case of a transsexual male who tries to be a woman, or the generation of sperm, in the case of a transsexual woman trying to be a man, does not change the structure of reality. 

The removal constitutes mutilation and the construction of artificial organs with no reproductive function does not alter the gender or sex of the person. Medical science confirms that our identity as male or female affects even our brains. In addition, even the physical appearance must be sustained by massive doses of synthetic hormones.

The argument that GRS is somehow "mutilation" fails to appropriately examine the consequences of failing to provide that surgery for transsexuals.  Here is where the whole person arguments that the religious love to throw around are obliged face the fact that GRS is part of a protocol aimed at ensuring that the whole person is as congruent as possible.  No more, and no less.

In 2002 the Congregation for the Doctrine of the Faith of the Catholic Church issued a letter sent without public release to every Bishop. It clearly stated that such surgical procedures do not alter a person's gender and that in no circumstance are baptismal records of such individuals who have undergone them to be altered. Further, the document made clear that no one who has undergone such a surgery is eligible to marry, be ordained to the priesthood or enter the religious life. 

At the time the letter was received from Rome, Bishop Wilton D. Gregory of Belleville, Ill., was the President of the U.S. Bishops' conference. He sent a letter to all US Bishops in which he wrote "The altered condition of a member of the faithful under civil law does not change one's canonical condition, which is male or female as determined at the moment of birth." 

The Gender Identity Movement insists upon the recognition in the positive law of a newfound right to somehow choose one's gender. They insist upon laws which accommodate, fund, and enforce this newfound right. Those involved in the activist wing of the movement want to compel the rest of society to recognize their vision of a brave new world or face the Police Power of the State.

In short, when you distill the entirety of their argument down, it still reduces to preserving their religiously borne right to treat others as second class citizens.

If the great danger that transgender people pose to the Catholic Church is that their presence and existence will someday force the church to treat all people as equal members of society, then perhaps the Church needs to revisit its dogma and practices with an open heart and mind.  It is hard to argue that would be a bad thing.