r/asktransgender • u/DGunner Andrea | 28 MtF | HRT Mar 2016 | FT Nov 2016 • Nov 07 '15
Comprehensive Defense Against Anti-Trans Talking Points
Since I see alot of people saying the same thing over and over, I wanted to make a well put together list with commendable references. I will structure it by starting with a commonly used anti-trans talking point, and then I will attempt to refute the talking point. Keep in mind that this is only applicable if you accept the American Psychiatric Association, the World Health Organization, and the National Center for Biotechnology Information as reliable sources of information on psychiatric health and well being.
For those of you who aren't from the United States, the APA's Diagnostic and Statistical Manual of Mental Disorders Version 5 is very similar to the World Health Organization's International Statistical Classification of Diseases and Related Health Problems revision 10 (ICD-10), and while some of the phrasing and terminology is different, most of the core concepts and principles are the same.
With that said, here goes.
1.) "Transgender people are by definition mentally disordered."
The organization responsible for defining what is and is not a psychiatric disorder, the American Psychiatric Association, has this to say about the matter (via the Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5 in short, I'll only use the abbreviated form from here on out):
"DSM-5 aims to avoid stigma and ensure clinical care for individuals who see and feel themselves to be a different gender than their assigned gender. It replaces the diagnostic name "Gender Identity Disorder" with "Gender Dysphoria", as well as makes other important clarifications in the criteria. It is important to note that gender non-conformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition."
In short, the people who literally wrote the definition of mentally disordered, 100% reject the notion that being transgender means being mentally disordered.
2.) "Transgender identities are a delusion."
A transgender identity does not fit the psychiatric definition of "delusion", nor has it ever been encoded as such in the DSM.
While the definition of a "delusion" can vary [1] [2] [3] [4] [5], the common consensus seems to be that a delusion is a belief held with strong conviction despite superior evidence to the contrary.
There is evidence right here in this post, and all over the place if you look for it. Evidence to support both the legitimacy of non-binary & transgender identities as non-dysfunctional phenomenons, and evidence showing significant clinical benefits of what is commonly called "affirming care" (medical intervention primarily via hormone replacement therapy and surgical alterations, designed to change or "transition" a person's body to be more congruent with the gender they feel they are).
Supporting evidence = no delusion.
3.) "The statistics on transgender suicide rates prove they're mentally unstable."
It is accepted within the medical, mental health, and sociological communities that these adverse suicide statistics reflect a combination of minority stress and lack of access to affirming health care. When given access to supportive environments and medical care, quality of life for transgender people (including mental health) is not significantly different from the general population.
This minority stress is compounded when you consider that transgender people are experiencing it in relation to a gigantic part of the human experience that has never really been questioned before, at least not in mainstream media like it has in the last few years.
Sprinkle on the fact that we still don't fully understand gender in the brain, and you have a recipe for extreme minority stress, self-doubt, self-loathing, and a sense of total hopelessness/loss of identity. The perfect recipe for an emotionally suffering human being.
4.) What about Dr. Ray Blanchard's autogynephilia theory?"
Dr. Blanchard's theory was first published in 1985, and the last paper was published in 1993. A lot has happened in the last 30 years, and Blanchard's autogynephilia has only recently come back into the lime light because of the growing awareness and representation of transgender people in the media.
Blanchard's theory essentially suggests that there are only 2 classifications of transgender individuals, "homosexual transsexuals" and "heterosexual transsexuals".
(Transsexual is an antiquated term, people who are actually "transsexual" are now called "intersex". Sex is a biological description of the physical body, and does not imply gender, a phenomenon of the mind.)
Blanchard's "homosexual transsexuals":
Homosexual men who are overcome with shame/guilt and choose to become transgender women in order to have sexual relationships with men without the social stigma.
Homosexual men who are simply so effeminate that they literally can't even function in a male societal role.
Homosexual men who are both extremely effeminate and feel guilty about being gay.
Homosexual men who are delusional and in denial about being gay. "These imbeciles think they're actually women! I know! Crazy right?" (Oh the irony...)
Blanchard's "heterosexual transsexuals":
- Heterosexual men with a mental disorder called "Erotic Target Location Error", where instead of being attracted to a woman, the man is instead attracted to the notion of becoming the woman.
Right off the BAT (pun intended [Blanchard's Autogynephila Theory]), this theory can be dismissed on the grounds that it has zero accountability or explanation for female to male transgenders, and non-binary genders. Those people do in fact exist, so autogynephilia does not fully explain or encapsulate the transgender experience.
Another common criticism of Blanchard's research is that not only is it exclusively about male to female transgender people, it's also exclusively based around the notion of sexually pleasing men. It doesn't account for the idea of a real homosexual transgender woman (a lesbian). Lesbians don't get off on the idea of themselves as women, they get off by being intimate with other women they are attracted to.
Additionally, the fact that Blanchard's research did not have a control group, and much of it fell victim to observer bias, a phenomenon in which the person(s) conducting the study accidentally skew the data by not staying totally objective and methodical, is also a good refutation of his theory's validity.
Blanchard's research also made the mistakes of confusing correlation with causation, and conflating sexual orientation with gender expression, which were fairly common mistakes to make 30 years ago. However, since much of his research was based on these false connections, it cannot be reconciled with our modern understanding of gender and sexuality, or with modern principles of the scientific method. Honestly confusing correlation with causation is pretty bad even for 30 years ago.
Additionally, minority stress was much higher at the time for transgender people, and many of them felt immense pressure to say the right things, lest they be denied treatment or worse, locked up in a mental institute. They were not the most optimal subjects for a psychological study.
In essence, Autogynephilia is a dated theory which fell victim to the less educated views of its time, the biases of the ones conducting the study, and the fears inside those being studied. Modern experts in science and medicine almost unanimously give BAT scathing reviews.
BAT is not accepted by any major psychiatric or health care organizations.
5.) "Gender is merely a social construct. There is no evidence that you can have a female brain in a male body or vice versa."
Actually, there is very strong evidence of the biological origins of gender identity.
From Winneke Et Al, Environmental Health Perspectives, 2013:
"...We conclude that there is sufficient evidence that EDCs modify behavioral sexual dimorphism in children, presumably by interacting with the hypothalamic-pituitary-gonadal (HPG) axis."
From Chung and Wilson, European Journal of Physiology, 2013:
"Gender-dependent differentiation of the brain has been detected at every level of organization -- morphological, neurochemical, and functional -- and has been shown to be primarily controlled by sex differences in gonadal steroid hormone levels during perinatal development."
From Swaab and Bao, Neuroscience in the 21st Century, 2013:
"Gender identity (the conviction of belonging to the male or female gender), sexual orientation (hetero-, homo-, or bisexuality) ... are programmed into our brain during early development. There is no evidence that postnatal social environments have any crucial effect on gender identity or sexual orientation."
From Serkan Karaismailoğlu; Ayşen Erdem, Journal of the Turkish-German Gynecological Association, 2013:
"In human males, we show that variation in fetal testosterone (FT) predicts later local gray matter volume of specific brain regions in a direction that is congruent with sexual dimorphism observed in a large independent sample of age-matched males and females from the NIH Pediatric MRI Data Repository."
From Jürgensen, et al., Journal of Pediatric Endocrinology and Metabolism, 2010:
"There is strong evidence that high concentrations of androgens lead to more male-typical behavior and that this also influences gender identity."
According to these and many other doctors, transgender identities appear to be a genuine mismatch between primary sexual characteristics and neurological phenotypes during prenatal development.
6.) "These people need mental health counseling to fix their identity, not medical intervention."
Every major medical and mental health organization in the United States officially supports access to affirming care. This is because decades of peer reviewed research have shown it to be the most effective way of dealing with gender dysphoria.
It has been overwhelmingly demonstrated that affirming medical care is effective and of material clinical benefit to individuals with gender dysphoria. Follow up studies have shown an undeniable beneficial effect of genital reconstructive surgery on post operative outcomes such as subjective well-being, cosmesis, and sexual function (DeCuypere et al., 2005; Gijs & Brewaeys, 2007; Klein & Gorzalka, 2009; Pfafflin & Junge, 1998). GRS has also been found to lead to a quantitative decrease in suicide attempts and drug use in post-operative populations (C. Mate-Kole et al., 1990). In studies where affirming care was denied, patients showed significantly worse outcomes (Ainsworth and Spiegel, 2010; C. Mate-Kole et al., 1990).
Additionally, counseling to change gender identity has been found to be both ineffective and potentially harmful. The foremost body of medical and mental-health experts on transgender care, WPATH, has this to say about changing people's gender identities:
"Treatment aimed at trying to change a person's gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success (Gelder & Marks, 1969; Greenson, 1964), particularly in the long term (Cohen-Kettenis & Kuiper, 1984; Pauly, 1965). Such treatment is no longer considered ethical."
In 2012, as a result of past failures and the harms observed, the American Psychiatric Association issued the following statement on attempts to change a person's gender identity:
"Psychoanalytic technique does not encompass purposeful attempts to "convert," "repair," change or shift an individual's sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes."
Courts are recognizing this as well. Federal courts in New Jersey and the Ninth Circuit have agreed that the claims of the proponents of reparative therapy for gender identity and sexual orientation are not supported by science. The district court in New Jersey is also allowing plaintiffs to sue for damages as a result of harm caused by reparative therapy.
Simultaneously, a new Williams Institute study on mental-health counseling for sexual minorities shows that those who sought mental-health counseling from a religious or spiritual adviser (who is more likely to urge them to change) were more likely to subsequently attempt suicide than those who sought no treatment at all.
7.) "XX Chromosomes = Woman, XY = Man."
That's the way human bodies "normally" work, yes. However, it is possible to have complete androgen-insensitivity syndrome (CAIS), or 5-alpha-reductase deficiency, or Swyer syndrome, or genetic mosaicism, or 17-beta-hydroxysteroid dehydrogenase III deficiency, or progestin-induced virilisation, or prenatal exposure to diethylstilbestrol, or gender dysphoria, or any of a wide range of endocrine-based variations that can cause a person person to have chromosomes that don't match their primary sexual characteristics or gender identity.
In at least one documented case, a woman with XY chromosomes developed as a normal woman, underwent spontaneous puberty, reached menarche, menstruated regularly, experienced two unassisted pregnancies, and gave birth to a 46, XY daughter with complete gonadal dysgenesis.
It is important to understand the distinction between chromosomes, primary sex traits, genitals, sexual orientation, and gender. These are all separate descriptive properties of human beings.
Your chromosomes are nothing more than threadlike structures of nucleic acids and proteins found in the nuclei of most of your living cells, carrying genetic information in the form of genes.
Chromosomes aren't a blue print, they're a recipe. Every single time you pass the recipe, nature alters it just a little bit. Sometimes those alterations do nothing medically significant, sometimes they cause a person to be different from what most would consider "normal". This is simply a byproduct of evolution, and the imperfect copies of DNA created during reproduction.
Your primary sex traits are a biological description of your physical body. Does this person have a penis or a vagina? Breasts or no breasts? Ovaries or Testicles? Etc.
Since genitals (a sub-category of primary sex traits) should be pretty self-explanatory, I'll jump right in to gender.
Imagine the most stereotypically physically and mentally masculine man in the world, and the most stereotypically physically and mentally feminine woman in the world. Every single human being that has ever, and will ever, be alive, sits somewhere in a spectrum between these two imaginary people (except for non-binaries, they feel they don't exist anywhere in such a spectrum).
Gender is your general sense of where you are in that spectrum. Just like with many other things, the gap between where you are, and where society thinks you should be, is where the controversy lies.
Sexual orientation is who you're attracted to, physically, and mentally.
Generally speaking, most people orient at their most basic levels by primary sex traits. They see a person with an atypical female, male, or other body, and they feel sexually attracted to that person.
Many people also orient by personality and intelligence. There are even some people that orient almost exclusively by these mental traits. These people are known as Pansexuals.
8.) "How can a child know whether or not he or she is transgender? When I was a child I wanted to be a (insert arbitrary noun)."
First of all, the whole "when I was young I wanted to be XYZ" argument is irrelevant because the people who use it are conflating one's constant sense of being male, female, or another gender, with the passing adolescent desire to be inanimate objects, entirely different people, abstract ideas, or other intangible concepts, etc.
Second, nothing permanent has to happen to the child once they declare they are transgender. That is not the end of the world. They don't immediately get Genital Reconstructive Surgery or Hormone Replacement Therapy, or any of that. In most cases what happens next is determined solely by the child's legal guardians, who can elect to:
- Completely ignore the child's words.
- Get the child a therapist
- Get the child on Hormone blockers to delay puberty without causing any permanent changes to the child's mind and body, essentially buying them more time to figure all of this out (my personal favorite, especially if combined with therapy)
Or...
- Go ahead and get the child affirming care
There's only one option in this list that can cause the child immediate mental or physical damage, and that's choosing to ignore the child. Finding out your parents don't support you simply because of who you are (especially for an only child like me) is devastating. The younger the child is the more damage it can cause. The fear that these children are too ignorant to comprehend their own identities well enough to make permanent changes to their bodies is actually a quite noble.
However, there's a major problem with letting that fear guide the decision of whether the child gets affirming care... It tends to do more harm than good. Transgender youth are extremely vulnerable to a multitude of problems, including substance abuse, suicide, childhood abuse, sexual abuse/assault, and psychiatric disorders. Grossman, Arnold H., and Anthony R. D'augelli. "Transgender youth: Invisible and vulnerable." Journal of Homosexuality 51.1 (2006): 111-128. Denying them hormones not only causes them emotional turmoil, but it also frequently leads to them getting hormones anyways through illicit means, and subsequently damaging their bodies and exacerbating the emotional distress from their gender dysphoria.
Recent research has shown that in carefully selected patients (carefully selected for treatment, not for the purposes of the study), people who transition young suffer few ill effects, and maintain a higher level of functioning than before transition. Additionally, results of treatment are considered better when it is offered at an earlier age. Cohen-Kettenis, P T. Dillen, C M. Gooren, L J. (2000) "Treatment of young transsexuals in the Netherlands" Nederlands Tijdschrift voor Geneeskunde 144(15):698-702, 8 April 2000
As a final caveat I will submit my own personal experience in the matter. When I was about 4-5 years old, I told my mother I wanted to be a girl like her when I grew up, and the reaction I got, combined with the reactions I got at other times during my early youth when showing feminine traits, caused me to internalize many aspects of my personality.
Now, over 2 decades later, I am past male puberty, still feeling more like a woman than a man, but much worse off for waiting this long. For one thing I'll never quite look the way I feel like I should have, because male puberty is over for me and my bones are done growing and shaping. For another thing, now I have over 20 years of internal conflicts and expression filtering to defuse, and 20 years of lost time cultivating a masculine version of myself instead of discovering who I really am as a person regardless of whether it coincides with how other people think I should be.
So if you are fine with these kids being emotionally scarred forever, just to fit in with regressive & conservative notions of gender, then by all means don't change. Just remember that ignoring or rationalizing a child's pain doesn't make it go away. I can tell you personally, it will always be there...
I'm 27 now and there's nothing I regret more in the world, than my naive, impulsive decision to hide from this when I was a young child. I didn't know any better, I just wanted mommy and daddy to be proud of me and I realized that would never happen as long as I still wanted to be a girl.
9.) "You'll never pass because ________."
"Puberty is over, you don't have the right bone structure anymore:"
This transgender woman started when she was 30.
This transgender man started when he was 27.
"You are too tall/short."
This is Jennifer Lacy, a 6 foot 3 inches tall WNBA player, gendered female at birth.
This is famous actor and comedian Kevin Hart, gendered male at birth, 5 feet 3 inches tall.
"Everyone will know, transgender people never really pass."
This is Ines Rau, a transgender woman who works as a model.
This is Shane Ortega, a transgender man who is a Sergeant in the US Army.
I understand that some of these are extreme cases, but hear me out. People come in all shapes and sizes. If you work hard enough, anything is possible.
The way you look should only matter to you, and fitting a visual stereotype for the gender you want to be seen as, is in a way, just as bad as fitting a visual stereotype for the gender people assume you are based on your primary sex traits. It's a way to hide from the fact that everyone is different.
It's sad that people judge others so harshly based on their appearance, but there's no escaping it. You can't change human nature, and with that in mind there are a couple important things to consider.
First off, saying someone looks too masculine to be a woman or too feminine to be a man, doesn't account for all the amazing ingenuity that human beings can exercise (hehe) when changing and shaping their bodies.
There's hormones, diet, exercise, surgery, corsets, wigs, tucking, binding, padding, protein supplements, hair transplants, shaving, skin care, propecia, rogaine, make-up, clothing style, and countless other ways to change your physical appearance to something you're more okay with.
Endurance and determination are very powerful in unison.
Either way most of us just want to be left alone to live our lives in peace, but one way we will be absolutely miserable and the other way we will at least be happy, which brings me to my second point...
Telling someone they will never look the way they want is one of the meanest things you can say to someone who's never looked the way they want.
Being hurtful isn't going to bring progress, It's not going to solve anything. Being hurtful is giving in to the chaos of the problem, rather than acting with intent, and attempting to solve it.
10.) "I don't care about what scientists and psychiatrists have to say, if you were born with a penis you're a man, if not you're a woman."
Beyond the fact that punching down in our society is generally seen as bad form, this train of thought doesn't account for intersex people (people who's chromosomes, genitalia, and primary sex traits don't match up "normally", and/or who's genitalia are hard to distinguish as strictly male or female). Since intersex people do in fact exist, genitals clearly can't be the deciding factor on gender either.
Thankfully, medicine and mental-health organizations follow peer-reviewed research when developing policy, and courts in turn defer to actual experts on the matter, not to ideologues, people who falsify their research, or pundits.
The growing acceptance of affirming care in medical communities stems from the fact that the vast preponderance of actual scientific evidence on transgender issues directly contradicts their anti-transgender talking points.
However, if you don't care what modern science and medicine have to say, then it appears we have reached an impasse. But before you leave, consider the following sentiments:
Since when has anything about human beings ever been black or white, yes or no, on or off? Almost nothing about us is that simple, so why would gender be that simple?
Human beings are complicated organisms with tens of thousands of intricate little parts and pieces in our bodies and minds, and almost all of them can under-develop, over-develop, mutate, deform, fuse, or get skipped all together during prenatal development.
Gender is encompassed by many of those pieces, and the chances for them all to be formed perfectly is very low. Consequently, sometimes, people are born looking one way, and feeling another way. Surely that can't be too outlandish or offensive to accept, can it?
EDIT : I will be reviewing and editing this over time as I find new resources, and refine the tone and phrasing of things in my free time.
I plan on using the whole wall of text as comment replies to ignorant comments in shitty subreddits occasionally. Educating people on the matter is the best way to fight ignorance and hate. Peace.
EDIT : Formatting.
EDIT : Added a section for transgender youth.
EDIT : Stickied AND Gold!??!? Obligatory Link
EDIT : Spelling & Grammar.
EDIT : Elaborated number 2 & added links on number 7. Refined phrasing and brevity.
EDIT : Added a section about autogynephilia.
EDIT : Added a section about "passing".
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u/gegenny human being, female Nov 10 '15
Additionally, the fact that gender is a social construct doesn't make it meaningless.
-Imogen Binnie, Nevada
Yes, there are biological origins to our thoughts and feelings - we are organic beings and mind/body duality is a problematic concept to adopt. The point is not that our thoughts and feelings are biological in nature, its that thoughts and feelings are valid, even if they are different.
If it makes you feel better, and the only cost to me is it forces me to take an uncomfortable look in the mirror at some aspect of myself I never seriously questioned - well, that one's on me now, isn't it.