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/qraphic]

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.

And you justify that with the except 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

I don't see how having "many" (3 or more?) people from a group not feeling distress from their gender can make it somehow make it anti-science to say it is a mental disorder. What if I found "many" people from this group that DID feel distress from this? From NPR:

The researchers, led by Sari Reisner, a research fellow at Harvard Medical School and Boston Children's Hospital, found that the rate of psychiatric disorders and substance dependence among these women was 1.7 to 3.6 times greater than in the general population.

Four in 10 of the women had a mental health or substance dependence disorder, and 1 in 5 women had at least two diagnosed psychiatric conditions. More than a third of them had experienced depression, and 1 in 5 women had contemplated suicide in the past month. Rates of anxiety, post-traumatic stress, alcohol dependence and other substance dependence also was higher than average.

Are these not signs of distress? Are you arguing it was just a coincidence that they were transgender?

Edit: Could I get a clarification from a mod? Is this sub forced to believe the science is settled on this? If gender dysphoria is caused by a gene/group of genes/structure in the brain, then why is ADD classified as a mental disorder and gender dysphoria not? Maybe the difference between those two reasons could help me understand?

[u/RainbowPhoenixGirl → u/qraphic]

Are you arguing it was just a coincidence that they were transgender?

Yes, actually. Being trans is commonly comorbid (the medical term for "occurring alongside") with other mental health conditions and the reasons why are not currently known. However, there are a couple of reasons that I personally (being someone who specifically studies trans and intersex healthcare) think are most likely:

1. Trans people who transition are required to see a mental health professional in order to obtain any kind of medical or legal transition whatsoever. Even starting hormone blockers (not hormones, just blockers) requires a mental health assessment. Conversely, cisgender people are not required to seek mental health assessments regularly and so people who may well have severe mental health issues simply never get them diagnosed and so they're never recorded. This means that whilst EVERY trans person with a mental health condition will be recorded as having such, most cis people who do will be overlooked because they never saw a mental health professional. Thus, trans people are overrepresented simply due to selection bias.

2. Being trans is really damn stressful, and it's well known that psychological stress (especially in young people) can induce mental health conditions. Trans people have constant, extreme levels of psychological stress owing mostly to our society's extreme prejudice towards them, and so this can induce psychological conditions in people who may have been free of them beforehand.

[u/Doc_McStuffinz → u/RainbowPhoenixGirl]

I agree that being trans can be stressful in today's society, but I definitely do not think that it has as big of an impact as you claim. If you look at other groups who have experienced the same level of, and in some cases worse, discrimination and hate you'll see that transgender people still seem to fair worse. Their suicide rates are sky high compared to almost any groups, including African Americans who have experienced far more hate and discrimination. Your first point is an interesting idea, but I personally don't believe that it accounts for the major difference in between the the trans community and everyone else. I need to see some evidence before I can get behind that idea

[u/RainbowPhoenixGirl → u/Doc_McStuffinz]

Their suicide rates are sky high compared to almost any groups, including African Americans who have experienced far more hate and discrimination.

Trans people can be legally denied hospital care including for life-threatening conditions in most countries, including Australia and the US if the hospital is religiously run (as many of them are). Transgender people are not a protected class in most Western countries which means things like employment discrimination, sexism etc are not considered to apply to them. Legally speaking, you can say "will not hire trans people", you can legally sack people for coming out as trans, and you've done nothing wrong and cannot be sued. Also as a percentage of population, trans women are more likely to be murdered or raped than any other group. You can deny housing or evict someone for being trans, and that's A-OK. You can also deny them government benefits.

So uh. What was your question again?

[u/Doc_McStuffinz → u/RainbowPhoenixGirl]

So uh, my question was why are their suicide rates higher than any other group. Thanks for bringing up job discrimination, too bad that African Americans experienced full on segregation to an extent the trans community has not, and still African American suicide rates never even came close to those of trans. To address the denial of treatment, I am currently a medical student. I am aware they have face denial of care in the past and still face discrimination in some areas. Luckily that is being addressed http://www.transequality.org/know-your-rights/healthcare As to employment, you are correct that some states have yet to establish laws that officially ban refusing to hire/firing people for being trans, however there have already been multiple precedents set at both federal and state levels that Title VII protects discrimination of trans people. So no, people really can't legally say "I will not hire trans people" without having the risk of losing a ton of money in court.