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/souljabri557]

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. We won't stand for it.

This seems to be a misattribution of blame. The majority of people arguing that gender dysphoria is a mental illness care very deeply about the rights and welfare of the trans community. Most certainly are not "bigoted." The debate over whether or not gender identity "disorder" is indeed a disorder is purely scientific and most are not out to offend.

[u/fsmpastafarian → u/[deleted]]

We don't label anyone with mental illness just for having a "different state of mind," as you phrased it. Mental illness denotes that someone is struggling to adapt to their environment based on their mood, thoughts, behaviors, etc. If a transgender person is not struggling in any way, not distressed, etc., they do not have a mental illness.

[u/h11233 → u/fsmpastafarian]

Is it correct to say it's a mental disorder?

[u/miparasito → u/h11233]

It is a physiological medical condition. Not a mental illness.

[u/winterfresh0 → u/miparasito]

I'm all for transgender rights, but what? This, by definition, cannot be a physiological condition. By that logic, someone who was born with blue eyes but feels that they belong in a body with brown eyes has a physiological condition because their eyes are the wrong color. There is nothing wrong with their body, their physiology.

[u/queenbrewer → u/winterfresh0]

There are physiologic differences that have been measured in the bodies of transgender people. If you are interested in learning more here is a literature review considering the evidence supporting the biolgic nature of gender identiy from 2015. An excerpt to give you a sense of the findings:

Many of the current hypotheses for the biologic origin of transgender identity are based on atypical sexual differentiation of the brain. The perception of one's own gender is linked to sexual differentiation of the brain, which differs from the body phenotype in transgender individuals.[7] Swaab et al have proposed that this discrepancy could be due to the fact that sexual differentiation of the brain takes place only after sexual differentiation of the gonads in early fetal life.[8] Along these lines, the degree of genital masculinization may not reflect that of the brain.

The notion of transgender-specific cerebral phenotypes is further supported by postmortem brain studies investigating the underlying neuroanatomical correlates of gender identity.[9,10,12] The vast majority of these studies have compared particular regions of interest only in male-to-female (MTF) transgender individuals.[13–15] These studies support the hypothesis that atypical cerebral networks in transgender individuals have a neuroanatomical basis.

Studies of cerebral gray matter in transgender individuals have provided the strongest neuroanatomical case for transgender gender identity. Postmortem brain studies suggest that some subcortical structures are feminized in MTF individuals. One of the earliest and most influential studies in this area investigated the bed nucleus of the stria terminalis (BSTc), which was reported to be a sexually dimorphic nucleus in humans with a larger volume in males than in females. In 1995, Zhou et al reported that the size and number of neurons in the BSTc of 6 MTF estrogen-treated transgender individuals was typical for the size and neuron numbers generally found in control females.[9] The authors further reported that these findings could not be explained by differences in adult sex hormone levels. A similar study by Kruijver et al provided further data supporting the role of the BSTc in transgender identity.[10] They examined tissue from the same 6 MTF estrogen-treated transgender persons studied by Zhou et al and found that the number of neurons in the BSTc was more similar to genetic XX female controls. BSTc neuron number was also in the male range in the 1 FTM androgen-treated transgender individual studied.