To transition, to have hormonal treatment or to have genital alignment?
Today this is not a question because dogmatic
treatment requires all individuals who wish to undergo
genital surgery to publicly, visibly live "the other gender" and
to have a minimum of one year of hormonal treatment (if one medically tolerates
it, no matter if one actually wants this or not!).
Furthermore dogma requires us to undergo
psychiatric treatment (no matter if there actually is an indication in the
form of "behavioural, social or emotional problems severe enough to
or not!) as well as to get "some other approval" (usually this means seeing
a psychotherapist, once again it does not matter if one actually needs
and/or wants psychotherapy or not or if this is meaningful or destructive) before a transsexual can even
be considered for such surgery.
First and foremost it is important to understand that how our genitals look, how we emotionally interpret our lives, how we physically perceive ourselves, how we want to be perceived by others and how we actually are perceived by others MAY OR MAY NOT HAVE ANYTHING TO DO WITH EACH OTHER and it has even less to do with the gender our driver's licenses, birth-certificates (or other id) show.
|It is true that a great majority of people who are legally or medically designated female live a (predominantly) female life, (usually) think of themselves as women, (most often) express themselves in a feminine way and (typically) get taken for women, however this is by no means the case for everybody! This gets particularly obvious when it comes to sexuality: Today it is accepted that a woman can express her sexuality in a heterosexual or in a homosexual relationship and that neither of the two is a manifestation of a mental illness nor is it a crime nor anything that would warrant any medical, legal or other intervention! Why this is not the case for the other 6 parameters (and the many I have not mentioned) I don't know.|
From my perspective it is clear that pretty much any and all combinations of the above parameters (and the ones I have not mentioned) would exist, somewhere, however to me it is also clear that none of these can be seen as "fixed either/or expression" - maybe with the exception of that legal or medical "male/female" designation in birth-records or driver's licenses. This is simply true because the real biological world comes in infinite variations of the theme we call 'life'. Or to put this differently: Personal identifications vary by their very nature and are individual!
|True, some of the possible combinations may cause problems, sometimes even severe ones. Sometimes they may even cause problems severe enough to really warrant mental treatment! For example a person who is designated female, thinks of herself as being a woman, expresses herself to the best of her ability in a feminine way but it still perceived by others as being male would potentially see this as a problem. Potentially, but not necessarily! And I agree, if this person would seek the assistance of a therapist this might make sense, might help her - but of course this decision is left to her!|
Now for transsexuals this is different. We are
mandated into mental-treatment and psychiatry by psychiatry itself, no diagnosable
problem is necessary! (see the
"mental or physical" page). Because psychiatry
wants to put a label onto people before treatment can be dispensed in the absence of a
diagnosable problem one is simply invented, called "Gender
Dysphoria" and defined as an undiagnosable (except by
self-identification), invisible, untreatable and very
severe condition each and every transsexual (and nobody else) is said to suffer from! Again, it does not
matter if we actually are dysphoric of our biological gender or not and if so, of
which aspect (i.e. social presentation, social interactions,
self-perception, physical sexuality, emotional sexuality, hormonal levels - just to name a
Fundamentally of course this means that we - all human-beings, with the exception of physicians - are declared incompetent by medical doctors, in full support of their professional organizations, to decide or even know which gender we are! AND BECAUSE WE ARE ALL INCOMPETENT TO KNOW THIS, IT MUST NOW BE A MEDICAL DOCTOR WHO MAKES THIS DETERMINATION, EITHER BY PUTTING "THE RIGHT ONE" ON A BIRTH-CERTIFICATE OR BY DECIDING WHO GETS SURGERY TO CHANGE IT AND WHO DOES NOT!
this basically means is that we can no longer decide which gender
we are, this is now decided FOR US, by a medical doctor. Obviously
the question arises in what way this doctor could be better (or equally,
or at all)
qualified to know what gender any given person should have???
In my opinion surgically assigning a gender to a person (or performing any non life-saving genital surgery) without consent of this very person IS FIRST DEGREE ASSAULT, the denial of such surgery if requested by an individual IS A FAILURE TO RENDER ASSISTANCE, or, as we are talking of medical doctors who have the duty to render such assistance, I would designate this as FIRST DEGREE PASSIVE ASSAULT. This should be treated accordingly and in any case, a person doing such things is not fit to practice medicine and should immediately be banned from practicing! If professional organizations are unwilling to do this, then the legal system should step-in - after all, a doctor doesn't practice medicine because of his education, he practices medicine because we, the people, give him a license to do so!
said this, not everybody who 'wants' genital surgery may actually need
it and this is certainly not right for just about anybody. Lynne
Conway's page about unsuccessful transitions (http://ai.eecs.umich.edu/people/conway/TS/Warning.html)
may give some insights here.
In the end this is all about finding a meaningful balance between the freedom of expression and the protection of the individual.
However if, as so often in transgender-care, the protection of the individual becomes more hurtful, destructive and damaging than no protection would be and at the same time there is no impact whatsoever to other people or society at large then there is clearly something badly wrong!
After all, we hardly do any good if - in an extreme example - we drive an individual into suicide as a measure to potentially prevent her from making the mistake of a lifetime...
The current set-up dogma and the medical community
forces onto us is harmful to most transsexuals, psychotherapy is often a
lot more destructive for us than it is beneficial, it keeps the
transsexual in the role of 'transsexual' instead of socially functioning
individual, it keeps the person focussed on a destructive and painful
past rather than on constructing a beautiful future! (After all, the
very notion of working-up our past isn't applicable because that past
was for all intents and purposes not ours!).
There is a saying: Nothing in medicine is absolute! I think it is high time for physicians to recognize that this is true even when it comes to their absolute right to treat a patient. Because sometimes the only ethical decision is to allow the patient to treat him/herself at his/her own discretion!
Of course the main problem here is not
that these professionals completely misunderstand transsexuality, the
main problem is that we are legally forced into the care of these
people in the first place because our medications are not available to
Psychiatrists treating transsexuals is a classic case of "the wrong tool for the wrong job!".
In the end there needs to be the recognition that MAINTAINING NORMAL LEVELS OF SEX-STEROIDS IS A HUMAN RIGHT, that this therefore cannot be prescribed, denied, withheld, limited or mandated by a medical practitioner or anybody else!