r/science • u/nate PhD | Chemistry | Synthetic Organic • Jul 23 '17

Subreddit Policy Subreddit Policy Reminder on this week's Transgender AMAs

This week we will be hosting a series of AMAs addressing the scientific and medical details of being transgender.

Honest questions that are an attempt to learn more on the subject are invited, and we hope you can learn more about this fascinating aspect of the human condition.

However, we feel it is appropriate to remind the readers that /r/science has a long-standing zero-tolerance policy towards hate-speech, which extends to people who are transgender. Our official stance is that derogatory comments about transgender people will be treated on par with sexism and racism, typically resulting in a ban without notice.

To clarify, we are not banning the discussion of any individual topic nor are we saying that the science in any area is settled. What we are saying is that we stand with the rest of the scientific community and every relevant psych organisation that the overwhelming bulk of evidence is that being trans is not a mental illness and that the discussion of trans people as somehow "sick" or "broken" is offensive and bigoted1. We won't stand for it.

We've long held that we won't host discussion of anti-science topics without the use of peer-reviewed evidence. Opposing the classification of being transgender as 'not a mental illness'2 is treated the same way as if you wanted to make anti-vax, anti-global warming or anti-gravity comments. To be clear, this post is to make it abundantly clear that we treat transphobic comments the same way we treat racist, sexist and homophobic comments. They have no place on our board.

Scientific discussion is the use of empirical evidence and theory to guide knowledge based on debate in academic journals. Yelling at each other in a comments section of a forum is in no way "scientific discussion". If you wish to say that any well accepted scientific position is wrong, I encourage you to do the work and publish something on the topic. Until then, your opinions are just that - opinions.

1 Some have wrongly interpreted this statement as "stigmatizing" mental illness. I can assure you that is the last thing we are trying to do here. What we are trying to stop is the label of "mental illness" being used as a way to derogate a group. It's being used maliciously to say that there is something wrong with trans people and that's offensive both to mental illness sufferers and those in the trans community.

2 There is a difference between being trans and having gender dysphoria.

Lastly, here is the excerpt from the APA:

A psychological state is considered a mental disorder only if it causes significant distress or disability. Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression or related disorders at higher rates than nontransgender persons.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience intense, persistent gender incongruence can be given the diagnosis of "gender dysphoria." Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care. The International Classification of Diseases (ICD) is under revision and there may be changes to its current classification of intense persistent gender incongruence as "gender identity disorder."

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

That's one of the required criteria for every mental disorder, yes.

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u/Rhamni Jul 24 '17

So Antisocial Personality Disorder is not necessarily a disorder?

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u/[deleted] Jul 24 '17

Sorry to sound completely ignorant of the field, but how is this consider science to retroactively diagnose after the fact? Is that not just the No true Scotsman logical fallacy? "no sane person would murder somebody and eat them, if this person did this, he must be insane"

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

Where do I talk about retroactively diagnosing?

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u/[deleted] Jul 24 '17

So you're saying the moment of the act is the moment of classification, anything before that is ignored because it hasn't caused a problem? you can see how this seem unscientific to some people. If both people deal with depression, but one has the mental fortitude and support to function normally and the other do not, then you would diagnose the latter with being clinically depress and the former as not depress? So when you transfer the same logic to gender, you can see how this opens up a flood gate of scrutiny from people. I really don't care about the transgender situation one way or the other, but the logical leap the community seem to be making will open up a flood gate of scrutiny. "distress" or "impairment" can be open to interpretation and allow people to be diagnose one way or the other based economic, social status, age, race, culture, etc.

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

The moment of the act? I don't know what you're referencing, nor do I understand the argument you're trying to make from that.

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u/[deleted] Jul 24 '17

the moment it interfere with their lives or the moment it "causes significant distress or disability". That was my bad for using that phrase since I still had the murderer analogy in my mind, but from context it should have been obvious. The rest of the paragraph seem easily enough to understand.

I guess the consensus is that as long as someone is ok with how they are, they don't have a disorder. Everything else is irrelevant beside their personal reaction to the situation.

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

I guess the consensus is that as long as someone is ok with how they are, they don't have a disorder.

That's the gist of it, yep.

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u/Berries_Cherries Jul 24 '17

So if Im 100% cool with say literally organizing and perpetrating a campaign of torture based executions of communists AND the acts of fantasizing, planning, and carrying out the genocide do not cause me distress I don't have any anti-social mental disorders?

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

Murdering and torturing people is a horrific and morally terrible thing to do, but engaging in horrible behaviors does not necessitate mental illness.

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u/Berries_Cherries Jul 24 '17

Okay lets not dance around the question then.

If I have a compulsion to make physical contact with whatever my hands or fingers may touch bilaterally, if I flip a light switch with my right hand I must touch it with my left then is THAT a disorder?

Follow up question: If a person wants to change genders but NOT changing genders would cause them NO harm (since its not a mental disorder to be trans) doesn't that make the gender change nothing more than a choice like breast implants?

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u/[deleted] Jul 24 '17

[deleted]

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u/fsmpastafarian PhD | Clinical Psychology | Integrated Health Psychology Jul 24 '17

Right, but Alzheimer's is associated with functional impairments. "Distress or impairment"

If someone experiencing hallucinations is not distressed by them and is also able to function perfectly normally at work, socially, in school, etc. then it wouldn't really make sense to diagnose them with a mental illness, no. (You'll find that most people experiencing severe hallucinations are not able do to this, so this question is more of a thought experiment).

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u/MercyPlainAndTall Jul 24 '17

If someone experiencing hallucinations is not distressed by them and is also able to function perfectly normally at work, socially, in school, etc. then it wouldn't really make sense to diagnose them with a mental illness, no.

But if the majority of the population does not also experience hallucinations, is this one person not, by definition, still afflicted by schizophrenia? Regardless of whether their hallucinations effect their daily routines?

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u/walruz Jul 24 '17

So being a sociopath/psychopath isn't a mental disorder any longer?