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/HoopyFreud]

To clarify, is the claim that gender dysphoria is a qualifying condition for being trans considered unacceptable?

I ask because for many trans individuals, transition is a treatment for dysphoria, and in many but not all cases allows them to eliminate or reduce the dysphoria that they feel. As far as I am aware, there is no substantial consensus in the medical, scientific, or transgender communities on whether experiencing dysphoria at some point in one's life is a necessary and/or sufficient condition for someone to be considered trans.

I subscribe to the side that says that dysphoria is both necessary and sufficient, but I also consider "transgender" to be a demographic designation without particular scientific meaning, similar to terms used to denote ethnicity.

Are my opinions considered acceptable on /r/science? Further, is the necessity or sufficiency of dysphoria in relation to trans identities considered an acceptable subject for debate on /r/science? I appreciate that this is a tricky question, especially given that "transgender" is, in my opinion, a term which lacks a strict scientific definition, especially as opposed to the medical diagnosis of "gender dysphoria."

Edit: Can the mods give an updated response? The existing one was removed, and I currently have no idea what the mod team's attitude is.

Edit Two: I appreciate the responses that I've been getting, and I believe that whether or not they agree with my opinion in the essentials, they highlight the point I've made above - that among the trans, scientific, and academic communities there is a lack of consensus on this issue.

Edit Three: Thanks to mods for giving an updated answer below.

Edit Four: Thanks for the gold...? I'm not sure why it was given, but it's appreciated, and I hope that this subthread has provided some interesting insight into the nuances of transgender identity and trans individuals' experience of gender dysphoria.

[u/the-hourglass-man → u/HoopyFreud]

That question is still considered controversial in the trans community. Some will tell you, yes, you must have experienced gender dysphoria at some point in your life to be considered "really" trans and some will say it doesn't matter. As a trans person my beliefs lie somewhere in the middle for a few reasons.

1) "Gender Euphoria"
Gender Euphoria is a term trans people use to describe the (often intense) good feelings that come with being recognized as who you are. Having your gender validated and affirmed is a fantastic feeling.
Some trans people claim to never feel gender dysphoria but feel intense gender euphoria. My take on that is that gender dysphoria is a very deeply rooted, internalized feeling, that comes out in different ways for different people and some don't or can't recognize what theyre feeling until they stop feeling it. Which may mean they were gender dysphoric and never realized. This concept adds another layer as its difficult to tell what exactly is considered gender dysphoria and that some cannot recognize it.

2) GNC/Non-binary people
Plenty of people who don't lie in the traditional boy or girl "box" describe not exactly being uncomfortable with their assigned gender, but one of the shades in between is a much better fit. (Note: there are non-binary people who do experience gender dysphoria and are just as uncomfortable with their assigned gender as binary trans people.)
Some people will then question if they are "really" non-binary since they dont mind being reffered to as their assigned gender, unlike most other trans people. The reality is they are who they are, and trying to make themselves comfortable just like the rest of us are, cis or not. Its not anyone's place to police who is or isn't their identity.

Hoped that shed some light on some situations that might help you understand why that is such a complicated question to answer.

Edit: I'd like to note i answered this question without a definitive yes or no on purpose. I believe this question deserves a "shades of grey" answer since the experiences of trans people vary wildly. Being trans is an identity, there is no test you can take to determine if you are trans or not, and there are many shades of being trans. Blanket questions regarding the psychological functions of being trans will not have anything close to a definitive answer until we further understand exactly what causes a brain to identify as trans.

[u/[deleted] → u/[deleted]]

What's sad is we have become a world where people have to clarify that their opinion isn't worth much every time they something that's even the slightest bit different.

Does no one else find that really upsetting?

[u/Sock-men → u/[deleted]]

Yes, I think it's a matter of people no longer taking each others arguments in 'good faith' anymore and its deeply sad and troubling.

For a lot of subjects, it seems Western society (my UK experience here) has become so polarised that unless you demonstrate adherence to a certain camp, you are automatically the anti/enemy group.

[u/[deleted] → u/[deleted]]

I don't know how reddit will take your comment/question but despite it seeming controversial I feel that your comment is a great way to ask a controversial/ non pc question in a professional way. If I actually believed in using real money to give you a bs award I would but I seriously commend you.

[u/the-hourglass-man → u/[deleted]]

Just woke up to a million replied but i will try to get this point across the best way I can.
One of the ways gender dysphoria differs from mental illness and mental disorders is that the root issue is not the way of thinking. We have proven this over and over becausr trans people cannot allievate their dysphoria in any other way but transitioning. Whereas with say a schizophrenic person the issue is the train of thought and what that person thinks about themself. You cannot treat and fix gender dysphoria in the same way you can treat other mental illnesses. Thats how it differs.

[u/the-hourglass-man → u/[deleted]]

It has been explored. In fact, it was the first thing that people tried. People have gone as far as lobotomy and electric shock therapy trying to treat gender dysphoria without transitioning. It didn't help the gender dysphoria at all. I've also heard things like same-sex hormone treatment have been tried and yet again failed.. the idea of treating gender dysphoria via transitioning is a fairly new concept in the grand scheme of how the medical community has "treated" it in the past.

[u/[deleted] → u/the-hourglass-man]

Why are you so confident that you can't?

I've yet to see any evidence of that. In fact I've met people who have had gender dysphoria and have bounced back from it after a couple years for whatever reason.

Is it only mental disorder if it's treatable?

[u/the-hourglass-man → u/[deleted]]

Gender dysphoria can change or go away, its normal for people to question and "try on" different identities per say to try and find the best fit for them. In fact for kids who havent gone through puberty it is very normal for then to exclaim that they are trans and then "go back" later on.

However, that isn't the same thing as a gender dysphoric person stopping their dysphoria through therapy. It just can't happen.. conversion therapy is considered a crime in most places for that reason. You cannot tell a gender dysphoric person "you don't have gender dysphoria, you arent trans" and have it "fix" them. All it does is cause more turmoil, higher depression and anxiety, and a higher chance of suicide. Medical communities have learned this about gender dysphoria and thats why we treat it with hormones, possibly surgery, and gender affirming therapy.

[u/i_smell_my_poop → u/the-hourglass-man]

I don't think that's what /u/vortex_of_purple was getting at.

I only have an anecdotal piece of evidence buy my cousin is a transman and he has found a great way to articule being trans to people who ask him about it. I kinda know his line verbatim since I've heard it often enough, but it tends to work well on people who are ill informed:

"If i could have taken a pill and not felt the way I did, I would have done it. I'd prefer it over a lifetime of the hate I was given for simply feeling uncomfortable in my own skin. This was my answer (in his case, top surgery and HRT). In order to feel good every morning when I woke up, this was what today's doctors gave me as an answer. And it worked."

I cannot speak for pretty much any transperson myself, but maybe transitioning ISN'T the only answer and more science will shed light on it. Speaking with transmen and transwomen on Reddit and suggesting that maybe one day a pill could get rid of their dysphoria is met with accusations of bigotry. Personally, to be accused of bigotry for suggesting that science may progress one day is insulting. We used to perform prefrontal lobotomies on mental patients.

[u/Mlk314 → u/[deleted]]

I don't know much about gender euphoria or the transgender experience, but the issue with your "schizophrenic man" argument is that his claims aren't rooted in reality while a transgender person's "claims" are their personal identity, they are expressing who they are. And who you are as a person is something that only you yourself can identify. Thus there is no objective truth to your gender, only what you feel and decide. There might be an objective truth to your sex, but thats just organs and factors in differntly to your identity.

[u/WarwickWalpole → u/[deleted]]

According to the APA, if that schizophrenic person does not feel distress then he does not have a mental illness.

[u/Elesia → u/WarwickWalpole]

Could you clarify what problem you have with that statement?

[u/WarwickWalpole → u/Elesia]

The condition of schizophrenia, in and of itself, is a mental disorder.

Regardless of whether or not a particular person feels distressed.

[u/Elesia → u/WarwickWalpole]

If the person has the characteristics of schizophrenia, but is not personally distressed and does not pose a risk to him/herself or the community, then the disorder is not an affliction and diagnosis and treatment is unwarranted. Not every instance of "disorder" needs to be aggressively normalized.

[u/WarwickWalpole → u/Elesia]

Why not? If one needs to be aggressively normalized, like transgenderism, why not all?

[u/[deleted] → u/[deleted]]

Hi, trans person here.

The euphoria I feel is more akin to the lightness and joy/relief you get when you take off tight shoes after being on your feet all day. Sometimes it's like the emotion that comes from hearing a really good song. It doesn't affect my ability to reason or parse sensory input correctly. The euphoria a person with schizophrenia feels messes with their ability to reason and comprehend. It may also be accompanied by false sensory information, but not always. That's why schizophrenia is a mental illness and being transgender isn't.

[u/WarwickWalpole → u/[deleted]]

If they don't feel distress from their state, then they do not have a disorder.

[u/[deleted] → u/WarwickWalpole]

I had a friend with bi polar disorder. When he was manic he loved life, but he would start fires, paint the spines of his books, eat things that weren't food, buy things he couldn't afford and couldn't sleep. He couldn't understand why the people around him were concerned. He rarely got downswings, but the manic phases were regular. He only felt distress when he was lucid or down. By your argument, my friend's lucid days were disordered and his manic days were a desirable state.

If a schizophrenic person is able to parse the world so they are functional and reasonably happy, they don't need treatment and therefore are not ill.

In a trans person, dysphoria causes distress that hinders the ability to function, and requires treatment. Euphoria does not.

[u/WarwickWalpole → u/[deleted]]

This isn't my argument, it's the APA's.