Difference between revisions of "Talk:Gender identity disorder"

Latest revision as of 12:14, January 9, 2009

Iran

Source states:

• The state health organisation may also subsidise his operations.

Edit to mainspace says,

• in Iran Gender Identity Disorder is recognized and sex reassignment therapy, and surgery is compulsory, and paid for by the state

Now, the question is between the meaning of the weasel term "may" in the source document, which is a weak source to begin with, being only a news item and not a fatwa or official government ruling or document, and the editors declaritive statement here, "and is paid for by", which presumably is some sort of support for a planned economy or socialized medicine. The credibility of the contributor is at stake here. While this is a very interesting and "enlightening" contribution, I would respectfully request an explanation as to why this distortion from the source being cited? Rob Smith 14:41, 15 August 2007 (EDT)

First to address that this isn't a "fatwa": http://www.westernresistance.com/blog/archives/000901.html Iran: Islamic Fatwa Condones Changing Sex. If that source isn't good enough there are plenty more to be found with a Google search for "fatwa transsexual".

Next, I can see your point, and will alter the point that it's still up for debate on if their state health organization may subsidize it. While this could be seen as a support for socialized medicine, the difference is that Iran has a socialized medicine system. Regardless of its effectiveness or ineffectiveness, Iran's socialized medicine still may subsidize sex reassignment surgery. --Puellanivis 15:53, 15 August 2007 (EDT)

First of all, we shouldn't be debating on talk pages; secondly, all of this is more about sex change operations than the identity disorder. I deleted the article and suggest you add or propose adding some information to sexual reassignment surgery or somewhere similar.

And please choose scientific sources, rather than popular news articles or "Aphrodite" web sites. --Ed Poor ^Talk 16:21, 15 August 2007 (EDT)

I'm sorry, I don't know where the proper place to debate this issue would be, except in the talk page. Also, as GID is a current DSM disorder, the original introductory paragraph of this article remained appropriate.

Modern medicine, both internationally and domestically, has in general conceded that the most beneficial course of treatment for someone with GID is by following the Harry Benjamin Standards of Care, which require extensive therapy, and further medical treatment only if absolutely necessary. It requires sufficient therapy before hormones (3 months) and it requires one year of living in the new gender full time, with two doctors signing off one of which must be a Ph.D. in order to aquire surgery. Both check points require the therapist to evaluate the reasons for the patient's issues, and to choose the least invasive change to their life possible.

As such, not all individuals who are diagnosed with GID will have Sex Reassignment Surgery. Some are able to resolve their feelings sufficiently in therapy that they need no medical intervention, and can continue in their typical life before hand. Some necessitate going further, such that they would require hormone therapy, for many this alone is sufficient. Others find that they must go further, and the only way to be consistent with themselves is to have surgery in order to reassign their sex.

The therapists are the greatest devil's advocate that an individual will meet against. These are the people who will either deny or allow you access to what you feel that you need. Their job is to ensure that there is not some other reason you're seeking this change. For instance, to evade police, to evade creditors, to evade prison, they're actually homosexual, (they usually either need reparative therapy (yes, sometimes it's appropriate!), or therapy towards acceptance, but certainly not a sex change), it does not stem from some other mental disorder, and it does not stem from a psychologically tramatic moment or abuse (e.g. a girl is visciously raped, and as a defense mechanism the only resolution she can see is to become a man and never be vulnerable again. Definitely a need for therapy, but certainly not a sex change)

The therapists are also there to ensure that all therapy is towards the betterment of the patient, and that the patient isn't reaching further beyond what treatment would be beneficial to them. For instance, transvestites (heterosexual men who wear female clothing for erotic pleasure) may need therapy, and at most limited hormones, but it has been empirically shown by numerous bad results that a transvestite should not undergo sex change surgery. It's psychologically devastating to them, the rate of regret is enormous, and the results are tragic. To use fairly dramatic language here, hey typically enjoy their new "toy" for about a week or a month, and then their libido crashes and they find that they can no longer have a sexual response. They also find that people don't accept you as a woman just because you have the plumbing, they become socially astrocized, shunned, and become introverts and hermits.

I invite you to compare and contrast that story, with the typical transsexual story. It's psychologically relieving, rate of regret is minimal, and results are typical of any beneficial surgery. Mortality rates of pre-op transsexuals is near 50%, and afterwards is only slightly higher than non-transsexual mortality rates (This is mostly due to suicides). The transsexual typically feels uncomfortable but relieved with their new parts, and then grows in sexual satisfaction from their new anatomy. They have also been accepted as female before they had surgery, and are already well aware of the social obstacles that they face after the surgery, because they experienced it.

Ok, so I'm a bit off on a tangent. The purpose of this was to show that GID is not the same as sex reassignmenent surgery. Sex reassignment therapy (which does not necessarily include any physical intervention at all) is perscribed as appropriate, and as medical need dictates. Therefore, one person diagnosed with GID may simply attend a few therapy sessions, or they may be so fundamentally driven that the only reasonable medical course is to grant them sex reassignment surgery. Also noted, was that a source clearly indicated that Iran has a binding Fatwa that recognizes transsexuality as different from homosexuality, and in some cases declares it a legal behavior. --Puellanivis 19:04, 15 August 2007 (EDT)

Ok, let me get this correct: 40+ million Americans do not access to quality health care; meantime, medical doctors are taking men and surgically, supposedly, turning them in women, and vice versa. And this is called "therapy", and "medical treatment," etc.

This begs a question: if these so-called "healthcare professionals" were not spending their time doing "boob jobs" (as they are called in the trade), and actually were providing "healthcare," would there be actually be a "healthcare crisis"? Rob Smith 19:16, 15 August 2007 (EDT)

First, capitalist economy and capitalist access to healthcare. If you can pay for it, you get it. The highest quality health care in the world is located in Cuba, a communist state (unlike the former USSR spending all their money on Military, Cuba has primarily spent it on the medical field.) If you have a suggestion of how to provide everyone healthcare without telling the doctors that they have to do it... I'm all ears. If a doctor can get rich doing it, they likely will.

Therapy consists of sitting down and talking to a therapist, usually required to have at least an M.D. in Psychology, or Psychiatry. I do not think anyone would disagree that a disorder that causes a close to 50% success rate of suicides among those patients needs to be handled by talking to a Psychologist/Psychiatrist.

"Medical treatment" is provided only when absolutely necessary. It's ensured that the issue is not cosmetic, nor sexually motivated, but rather is fundamental to their identity as its causing them great distress. One can count the number of doctors performing Sexual Reassignment Surgery on one hand. I do not think they could take care of the 40+ million without healthcare. The number of doctors performing breast augmentation on otherwise healthy non-transsexual women is enormous... I think they could take care of the 40+ million without healthcare. --Puellanivis 19:29, 15 August 2007 (EDT)

Ok, so an not obfuscate an already obfuscated issue any further, the YEC crowd debates the age of the earth, and as colloquies to that, the age of the human species and human civilization. Most all agree, the species and civilization is 6 to 10K years old. Now in 6 to 10K years, never was it reported, to the best of my knowledge, that persons suffered from GID in need of "therapy" involving genital mutilation.

Pardon my frankness, but I am an historian, and part of my job is reporting on contemporary events. And my proferssion is as old as, and as respected as the medical profession, if not possibly older. And the techniques we use of the accumulated wisedom of the ages are not all that dissimiliar.

So, given that this "medical condition," in need of "therapy" and the surgical knife, did not exist prior to doctors learning how to do things like tonsilectomies and appendectomies, and they just converted thier knowledge and experience over to satisfy what appears to be some intellectual challenge or curiousity, and a "medical condition" appears to have been discovered or invented to explain their conduct, none of this acummulated wisdom appears to have an scientific basis at all.

This is just the professional opinion of one schooled to make such observations. But in my field (unlike the "professionals" who perform these genital mutilations), I understand my judgment may be wrong. Hence, I do not take actions that I cannot undo later (again, unlike these "professionals" who perform genital mutilations). Rob Smith 20:03, 15 August 2007 (EDT)

First, you passed over Eunuchs. Matthew 19:12 "(12) For there are some eunuchs, which were so born from their mother's womb: and there are some eunuchs, which were made eunuchs of men: and there be eunuchs, which have made themselves eunuchs for the kingdom of heaven's sake. He that is able to receive it, let him receive it." Some willingly gave up their masculinity for many reasons, a voluntary Eunuch could be described as a man with GID.

Second, you passed over the Hijra of India, which are a long known culture of Eunuchs in India, many of whom report their reasons for doing so was that they didn't feel like a man, but rather as a woman. Hijra were around before modern medicine with tonsilectomies, and appendectomies.

The scientific basis that exists to support sex reassignment therapy for transsexuals has already been empirically established already by modern medicine. Near 50% successful suicide rate to a relatively normal suicide rate. Also, while the cause of schizophrenia is still unknown, we still know empirically that giving schizophrenics anti-psychotics reduces the symptoms so that they can function in life. The process is treating a psychological distress with techniques that are know to resolve symptoms, even if a cause is still not known. --Puellanivis 20:22, 15 August 2007 (EDT)

(a) most ancient eunuchs you refer to were involuntary, that is to say, it was done to them fairly early in life, and in most instances for a poltical purpose (there was also supposedly an artistic purpose at one time, i.e. because the soprano voice was so cherished and males have larger lung capacity, some young boys were emasculated to make adult male singers for others entertainment); (b) as to Mt 19:12, the answer is right there, "All men cannot receive this saying, save they to whom it is given.....there be eunuchs, which have made themselves eunuchs for the kingdom of heaven's sake. He that is able to receive it, let him receive it." Honestly, I can't recieve it, that is to say I can't recieve the saying. And unless yourself or somebody else can recieve it (that is to say, understand it), "for the kingdom of heaven's sake," I would guess speculation would result in something quite opposite to God's truth. (c) there has always been crazies who emasculate themselves, just as you point out in the discussion of schizophrenia.

As to schizophrenia, that is the term Psychiatrists give to a condition that simply means "we haven't got a clue." As to the treatment with anti-psychotics, any generalization about that is meaningless. Since schizophrenic and psychotic conditions vary so widely, and so many are treated with the same medications, the results are very mixed. And it is a scientific fact, that many adult schizophrenics now in the 40 & 50s who were subjected to these experimental treatments from childhood beginning in the 1950s and 1960s steadfastly refuse to take anti-psychotic medications today, and are extremely suspicious of psychiatrists and medical doctors. This is just another embarassing fact on the road to progress. Rob Smith 21:01, 15 August 2007 (EDT)

Yes, most ancient eunuchs were involuntary, but even the best estimates of occurance of transsexualism in need of hormone therapy, or surgery is 1 in 23,000. Using current estimates as to the population in the past, at 1 B.C. we have 200 million people in the entire world, using incredibly simplistic approaches this yields an estimated world-wide population of transsexuals to be about 8,500 people world wide.

So... we continue to treat schizophrenics with treatments that are known to be less effective than the treatments given to transsexuals. Yet one is considered ok, because we've accepted the disease, and the other is not, because we have not. Lepers were long thought to be the unclean, and cursed by God, and still now there are numerous people in 3rd world countries who get leprosy. However the cause of leprosy is now known to be caused by bacteria, which is so difficult to catch that you have to already be susceptable to it in order to contract it, even if exposed to it. The Old law requirements for leprosy did little to actually prevent the spread of leprosy, it was merely the incredibly weak nature of the disease that prevented it from spreading. Now in our modern culture, we can treat leprosy quite easily, and in first world nations it is now so rare that it showed up in an episode of House M.D.

Modern Medicine has learned a lot over our history, and we're better now at curing disease than we ever have been. Just because we consider transsexuals the new lepers, does not mean we do not know now how to help, and ease their pain and suffering. Just like giving a deaf person a cocular implant so that they can hear (limitedly, but even just 10% is better than 0%). --Puellanivis 18:16, 16 August 2007 (EDT)

Two questions: (a) what do you mean by "transexual"? Firstly, you appear to state flatly it is a "disease", whereas as I understand the term "transexual", these are some sort of man-made beings that never existed prior to about the 1950s. (b) "The Old law requirements for leprosy did little to actually prevent the spread of leprosy"; this law was primarily segregation and quarantine. And I would probably dispute this premise, so perhaps you need more of a foundation for this claim. Rob Smith 16:15, 19 August 2007 (EDT)

(a) "Transsexual" is some person who suffers from Gender Identity Disorder to such a strong extent that they are certain that they are a member of the opposite sex, regardless of what medical treatment they have, or will receive. A more narrow interpretation of this would be those who have received surgical and/or medical alterations, and that these man-made medical alterations need be sufficient for the person to interact as a member of the opposite sex. However, whether we have an effective treatment now, as opposed to what we had before does not change the nature of the disease. A systemic bacteria infection was "known" since the beginnings of man, however not until the discovery of antibiotics was it possible to actually treat them in any sort of effective manner. (b) Leprosy is a very very weak bacteria, requiring 20 days to reproduce (as opposed to 20 minutes from some E. Coli strains). In fact it has as of July 2007 evaded all attempts to culture in vitro as it is so weak. Approximately 90% of the human population is naturally immune. Isolation and Quarantine have been shown scientifically to be entirely unnecessary to prevent its spread. While it is likely ideal to remove a person from their home, as they are relatively more likely to not be immune, if they are related. However total isolation and quarantine from the general populace, is entirely unnecessary. The Old law requirements for leprosy mimic more the known superstitious beliefs surrounding leprosy in non-modern cultures, as opposed to modern knowledge regarding information about leprosy which is now empirically and non-controversially known among doctors. --Puellanivis 17:31, 19 August 2007 (EDT)

Rather than just dump this to the mainspace article, I'd like feedback first

Gender identity disorder is a medical diagnosis for a mental disorder according to the DSM IV, which indicates a "strong and persistent cross-gender identification." [1] In previous version of the DSM, this has been called "Gender Dysphoria", but now that term is used specifically to refer to a pyschological criterion of GID which requires that "there must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex." [2]

In the ICD, this mental disorder remains known as the more common term "transsexualism", which as its first diagnostic criterion requires the individual to have a "desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment."

A set of International Standards of Care[3] guide most physicians, and therapists around the world in a widely accepted medical process that begins with Reparative Therapy intended to dissuade patients from the permanent and irreversible physical alterations that could seriously damage their mental health. Patients are expected, and strongly encouraged to attempt to resolve this disorder without physicial intervention, however when such therapy has been found to not make a positive impact on the patient, then the standards indicate physical interventions, which are focused and intended to improve the mental health of the patient, or ease their assimilation into the new role in order to alleviate stress from societal, and cultural pressures against transsexualism.

The following section in intended to deal with the motives, and models behind transsexualism.

How this condition relates to homosexuality is hotly debated. At the time of Kinsey's evaluation of human sexual behavior, transsexualism was modelled as being so homosexual that one felt a need to interact with heterosexual members of their own sex.

However, the Kinsey model fails to account for a significant amount of transsexuals, who appear to be attracted to the the gender that they identify as. As a resolution, modern and typically liberal transgender activists have tended to present a model that transsexuals are fundamentally a man or woman trapped in the body of the other, and that their sexual orientation is entirely independent of their gender identity.[4]

Critics of this common model for transsexualism, like J. Michael Bailey point out that such a model fails to properly account for the empirically evidence that transsexuals typically lie in two separate and distinct categories: whereas some males are so naturally effeminate and homosexual that it makes more sense to them to be women, than to continue to struggle and/or fail as men. These naturally effeminate transsexuals contrasts with all other transsexuals, who are described to have a form of non-harmful paraphilia, which consumes their erotic desires to view themselves as the opposite sex, and eventually motivates them to actually become the woman that they have imagined themselves to be. These non-natural transsexuals are empirically shown to share a common and frequent rejection from society, family, and friends outside of the transgender community as they remain notably distinct and different from natural females, regardless of how much surgical intervention, or behaviorial training they seek.[5]