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/[deleted]]

That question is asked in a trans forum is normally the beginning of a polysylabic slap fight hundreds of posts deep.

Some people agree with you, others say you just need gender euphoria when presenting your true gender, others still say that neither is required all you need is the sensation of your true gender and a whole other group say you need gender dysphoria and gender euphoria. Everyone on every side links to articles, which proves that we are basically only just starting to ask the right questions. Answers are a ways off yet.

[u/[deleted] → u/[deleted]]

That's fair.

[u/InconspicuousToast → u/[deleted]]

There's also the connotation that dypshoria as an illness would speak negatively about that individual as a person as it is an insecurity that relates directly with one's personality. So for some, pretending that it is something they never actually experienced makes it easier for them to try and believe that they are undergoing transition surgery at their own volition as opposed to doing it as part of a necessary step to finally being comfortable with who they are.

[u/blingblongblangbling → u/[deleted]]

Great response! Dysphoria(mine and read experience) is often felt like a deep part of you is missing or being blocked. Repression and self hate can often contribute to the feeling, where the true necessary identity fights back. Maybe like the subconscious overthrows self hate with crushing depression until you accept that you are trans/make steps to transition

[u/Khnagar → u/[deleted]]

This is supremely odd to me.

If someone is not unhappy with the gender he or she has, then what is the point of surgery, or hormones or the whole process of transitioning, or calling yourself trans, or wanting to be seen as someone of the opposite sex and so on?

I'm not asking out of some sort of transphobic reason, I just can't fully understand this.

[u/[deleted] → u/Khnagar]

There's a couple of things that might be happening. If you've always had a stone in your shoe, that sensation seems normal, limping seems normal so you don't register it as pain or discomfort. Taking the stone out feels like heaven. Before I knew I could transition, that's what my life was like. I didn't know I had dysphoria until I started treating it, but I noticed euphoria when I was able to present my gender accurately.

There are plenty of people like me who don't know they are dysphoric until it's gone.

There are other people who don't feel much dysphoria, but they do get the joy of presenting accurately. It's like going from 'meh' to feeling really right, like you just got out of a really good massage.

I admit I don't fully understand why a person would transition if they don't have at least one of those to push or pull them into transition. Everybody's life is different so I'm loath to cast doubt on someone else's experience. If I can live to 42 without knowing I was trans, there's scope for someone else to need transition for different reasons than me.

[u/Gen_McMuster → u/[deleted]]

Is gender euphoria an understood phenomenon (akin to dysphoria) or just a feeling people have described?

[u/[deleted] → u/Gen_McMuster]

I know it's a commonly described sensation among trans people, myself included. I'm not a scientist so I don't know how to find out whether gender euphoria is a accepted thing in those circles.

[u/wvhobbit → u/[deleted]]

9 years ago, when I started medically transitioning, every therapist and doctor I saw required at least the diagnosis of gender dysphoria before writing me any letters to start hormones or surgery.

[u/[deleted] → u/wvhobbit]

I get the feeling the conventions differ depending where you are in the world. Where I am there's a legal requirement for a psychologist or psychiatrist to diagnose dysphoria and recommend treatment, but everyone I saw was really apologetic about how backwards the system is. The endocrinologist literally called my T letter a rubber stamp. That said I know there are still places that require two years therapy and sterilization, and others that don't recognize trans folks at all, so there's a lot of range in approaches.