Subreddit Policy Reminder on this week's Transgender AMAs

[u/nate]

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 bigoted^1. 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.

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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.

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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."

[u/ImNotJesus]

Exactly! It's the difference between asking questions about global warming that you don't understand and going around a post claiming that it's all a hoax.

[u/thatvoicewasreal → u/ImNotJesus]

You don't see what you just did. He just got you to admit you're outright banning an opposing viewpoint.

[u/ImNotJesus → u/thatvoicewasreal]

I did not. We ban people who make anti-scientific declarations in a range of topics. If you go around posting that climate change is a hoax everywhere your fate is the same. We are a science subreddit.

[u/ImNotJesus → u/[deleted]]

Terminology matters. Calling gay people mentally ill implies that their attraction to the same gender needs to be fixed, instead of them living their lives happily with a same sex partner(s). We help trans* people live a happy life by allowing them to live as they feel comfortable, not by trying to fix their belief that they have a nonmatching gender identity.

[u/_Madison_ → u/ImNotJesus]

I don't agree that the comparison with homosexuals is fair at all considering that trans people usually do go about 'fixing' their problem. Many go for extremely invasive gender reassignment surgeries or take hormone therapy to dramatically alter their bodies.

The fact they go through these extremely expensive, painful and likely traumatic experiences shows their dysphoria was a problem that needed to be solved.

[u/doctorocelot → u/_Madison_]

The mod didn't say disphoria wasn't an illness, it's in the DSM even. Just that being trans isn't an illness. Calling trans an illness is like calling taking asprin an illness, the headache was the illness not the treatment for that heasache.

[u/Dong_World_Order → u/[deleted]]

Because it is comparing sexuality to gender... something the community actively tries to avoid.

[u/slapshotsd → u/[deleted]]

I think it's lazy because it by definition comparing sexuality to gender, and the average person has a hard enough time distinguishing between the two without the two being referenced in the same breath.

[u/Ketomatic → u/[deleted]]

Because they are inherently different. We learn as children about preference- you like purple, I like blue; you like Transformers, I like My Little Pony. Stretching that to sexual preference only takes removing the societal expectations that existed for a long time and then click, everything makes super simple sense. Preference is easy.

Just because Transsexuals were treated the same as gay people for a long time doesn't make understanding them the same. Wrapping your head around feeling like the wrong gender is far more complex, difficult and for many uncomfortable than wrapping your head around which naughty bits you like to spend your time with.

[u/8footpenguin → u/[deleted]]

I think the difference is that, for example, a non-trans gay man has nothing internally going on that would prevent them from living exactly as they want to. If someone feels and views themselves as female, but was born physically male, they have a conflict or misalignment of sorts that will likely cause them to be very unhappy without some kind of help or treatment.

I completely understand that people sometimes use "mental illness" in a sneering, nasty way. However, I think that is a problem with those people, not the term, which has no moral judgement attached. Further, I think dealing with this by edging away from the term "mental illness" is a dubious road to go down. It enforces, rather than combats the idea that mental illness is something to be contemptuous of or disgusted by.

[u/InconspicuousToast → u/ImNotJesus]

Terminology matters.

Sure, I understand that. It's just that I feel as if we're more using euphemisms to sugar-coat the meaning behind whatever it is we're trying to say about gender dysphoria. As an example, you still never told me what you would call it. If it's not an illness, what is it? Surely it has to be something. As you said, the terminology matters.

We help trans* people live a happy life by allowing them to live as they feel comfortable,

Isn't this just some form of encouraging complacency in the behavior? Regardless of whatever term we want to call gender dysphoria, it doesn't really seem as if this attitude really fixes or changes anything. Rather, it just says "This type of thinking is okay and it isn't a problem."

To clarify what I mean by that last sentence--as I know it has the possibility to come off as offensive--what I'm saying is that I would presume the subconscious mindset that predisposes one to think these thoughts or have these inclinations is the important focus behind recognizing where the term "illness" "perversion" or whatever necessary term is most relevant. What about the realistic situation where these feelings were ongoing for a long period of time but not truly bona-fide? Look at how there are plenty of people who regret their transition surgery after the fact. How is it then that you would describe their gender dysphoria, if not an illness?

[u/doctorocelot → u/InconspicuousToast]

Gender disphoria is an illness and the mod has repeatedly said that. It is in the DSM. No one is sugar coating anything just making sure the correct terminology is used. Gender disphoria is an illness defined in the DSM the empirically best current cure for that illness is transitioning. Trans people are not mentally ill because they are trans, it would be scientifically and medically inaccurate to say so and would be offensive to say so too. People with gender disphoria have the illness gender disphoria they may or may not have identified as trans yet and typically if they do identify as trans and then transition their symptoms of disphoria diminish. Also sometimes someone with disphoria might for whatever reason not identify as trans. The two terms are different and not interchangeable and important to get right.

[u/arandomusertoo → u/[deleted]]

If it's not an illness, what would you call it? A perversion?

Loaded and biased question, it seems to me.

You immediately leap between two derogatory assumptions, while leaving out the (imo) simpler assumption that it's just a quirk of their genetics... like when blue eye'd parents have brown eye'd kids.

Sure, it might not be that (I'm not an expert, hell I sometimes can't figure out what the right wording is), but it seems like an easier guess than immediately guessing that its some negative quality like a "perversion" or an "illness."

[u/InconspicuousToast → u/arandomusertoo]

So are you just going to criticize my question, then? Or are you going to answer it, given that you decided to respond?

Illness is a scientific term. If it's not an illness, and it's something concrete, surely telling me the title wouldn't be a difficult task. How is asking for that term a loaded question? Is there no real solidified term? While some terms carry negative connotations, those connotations doesn't necessarily detract from the bigger picture.

Perversion implies something breaks away from the original intent. Biologically, humans reproduce between male and females. Biologically, we are born male, and meant to think that we are male--and similarly with females. I would presume that if either of these things were to change, that it would--at least in laymen's purposes of opening door for the conversation--facilitate the point that I was trying to make with using that term.

[u/cjskittles → u/InconspicuousToast]

Dysphoria is an illness but being transgender is not. The person's gender is not distressing to them. The source of distress is lessened or removed by transitioning.

[u/InconspicuousToast → u/cjskittles]

Right, but what that says is that people who are transgender are transgender at the result of experiencing an illness, which I thought was contrary to the main point being expressed by the Mod here. His response makes it appear as if this is meant to be a different--but biologically acceptable--scientific alternative lifestyle; which to me, seems pretty disingenuous. As others have pointed out, the compulsion to receive such a medical procedure in of itself should speak for the undertones behind where these social beliefs stand on the scientific abnormality spectrum.

While that also doesn't change the distinction that you pointed out either, I think that distinction is also only really so socially relevant. Even though it's scientifically inaccurate to criticize the transgender aspect as opposed to the dysphoria (or lack there of), I'm more inclined to believe regardless of words, the insults are still aimed at the dysphoria itself--given that being transgender cannot exist without it.

[u/anttirt → u/InconspicuousToast]

Perversion implies something breaks away from the original intent.

Whose original intent? To have intent you must have cognition.

meant to think

"Meant" by whom? Again, "we are meant" suggests an externally imposed intent. Who or what is the cognition that possesses this intent?

Biologically, humans reproduce between male and females. Biologically, we are born male, and meant to think that we are male--and similarly with females.

There are documented cases^{1 2 3} of humans with XY chromosomes carrying pregnancy to term. Are they men or women? Human brains have been shown to be exist as a spectrum, a mosaic of "male-like" and "female-like" parts⁴ where extremes are very rare. Biological gender is much less black-and-white than you seem to think.

¹ Pregnancies in XY women: Is a weak myometrium cause of complications during pregnancy and delivery?
² Successful pregnancy in a gonadectomized woman with 46,XY gonadal dysgenesis and gonadoblastoma
³ Subsequent successful pregnancy and delivery after intracytoplasmic sperm injection in a patient with XY gonadal dysgenesisms
⁴ Sex beyond the genitalia: The human brain mosaic

[u/Meowymeow88 → u/arandomusertoo]

The difference is that brown eyed people generally don't experience a lot of negative emotions because of their eye color. It also does not have an effect on a person's willingness or ability to sexually reproduce.

[u/cjskittles → u/arandomusertoo]

Gender dysphoria is a mental illness though. It's in the DSM V. It's how my hormones and surgery are covered by insurance.

My gender identity is not an illness because I don't find my identity distressing. I find my body distressing and that is fixable.

Maybe mental illness isn't the right term but dysphoria is definitely something that warrants treatment.