Well, the individual I was having a discussion with above seems to have deleted her posts, which is a shame. In addition to making me look like an absolute psycho posting again and again and again, lmao.
However, I promised to follow-up on a few things namely talking about TiFs and trans-identified kids. I'll do some of that below, based off responses to a few things I read above.
Warning: extremely long and probably controversial. One of two final posts, I think (other than responses) until I've said my piece on this. I appreciate everyone who's bearing with me. I work darn hard at this and there is a point I'm getting to here.
A reminder: this issue is extremely sensitive. I endeavour to be objective but some readers will not like what I have to say. What I have to say is my personal opinion. It is not a clinical opinion and I do not have a lot of clinical experience in this area. It is an opinion based on countless hours a great deal of research both in the literature and by observing both trans-positive and gender-critical communities online (necessarily from an etic perspective.) If you're willing to trust me, just consider that I've read a dizzying amount of stuff so you don't have to. But, as always, just my opinion and my reading of things.
So in other words gatekeeping. Which I support as well to a certain extent. I guess the big question is what "actually diagnosed" means. They used to exclude autogynephiles (AGP) who were doing it for fetishistic reasons. Now it appears from casual observation that at the very least
a majority of trans-identified [natal] males (TiMs) who are visible in online spaces fall into that category. (I'm willing to consider the possibility that this is not a representative sample.) And what of people who have comorbid psych issues? I've talked about personality disorders above and generally those are considered some pretty fucked up people but not necessarily
non compos mentis except in extreme cases. Speaking super generally TiMs tend to have narcissistic tendencies and TiFs tend to have borderline/histronic tendencies. As I mentioned before this matches statistics that say males have more narcissistic tendencies and females borderline/histronic tendencies.
Consider for the moment the fact that "borderline personality disorder" has, in my opinion aptly, been criticized from a feminist standpoint as being an inherently gendered construct (
not to say it's not real, but to say that this cluster of symptoms was constructed by predominately male clinicians to describe a predominately female group of patients and that this is worth thinking about.) Borderline PD is very related to environmental issues i.e. trauma as well as intrinsic risk factors. The "gendered" nature of this diagnosis is mostly likely related to what we call
female socialization, which is something that I've mentioned before and will mention again. The concept is fairly self-explanatory: from birth, girls and women are socialized and subject to social structures that are ouroborically both dependent on them being female and
defining their femininity. Males also have corresponding
male socialization.
Central to the "gender critical" critique of the phenomenon and condition of transgenderism is the fact that natal males and females receive gender-congruent socialization before socially and/or medically trans-identifying. As such, given that the primary risk factors for personality disorders are believed to be environmental (including gendered socialization) and genetic (including chromosomal sex), then it is not surprising that trans-identified individuals display trends congruent to their natal sex. This along with
everything else which goes with gendered socialization is 'baggage' that follows them from their natal sex to their trans-identified "gender." A pair of heels, some hormones, a few make-up and voice lessons and even outright surgery is not going to change this fact. Thus do we see natal sex creeping into assumed gender. This is why, say the GC feminists, that you tend to see TiMs at more
assertively (as males are socialized to do) at the forefront of trans issues and even in terms of their (sometimes fetishistically-motivated) movement into female spaces, whereas TiFs are often more content to take a passive role. If you observe (or participate in) these communities, you will see ample examples of this.
But to return to the broader issue of mental health, having discussed personality disorders. How about psychosexual issues? Trans-identification
is one, but I refer more to individuals who, as I have alluded to at times, have fetishistic issues. I will preface this discussion by saying that the following is controversial: AGP is, by definition,
fetishistic. To briefly recap for people who may be jumping into read here: autogynephilia (AGP) is an "erotic target location error" (ETLE) which causes the object of sexual desire to be "displaced." In the case of AGP, sexual desire is towards the female, displaced unto some abstract idea of femininty often including fetishization of female clothes and other trapings of the opposite sex, which in turn is displaced onto an idea of oneself as female. This is why the AGP (at least initially) is though to cross-dress. Fantasies during masturbation may begin to focus on oneself being female and taking the receptive role in intercourse. At some point, things escalate into trans-identification. This, it is reasonable to assume, displays itself differently in different social/cultural contexts. Abnormal psychology is replete with different issues surrounding male fetishization of women's clothing, cross-dressing, etc. This phenomenon has almost exclusively been studied in men, and has usually been pathologized. Now it is not so: given what is in the sociopolitical air regarding transgenderism, AGP would seem to manifest itself in the development of a cross-sex "gender identity." The
concept of autogynephilia itself is under attack, being seen as dated and as accusing trans-identified males of sexual perversion.
The question would be whether AGP-pattern individuals are "real transsexuals" and whether they had ought to be admitted through the "gates" for medical transition. The horses is well out of the barn on this question, so perhaps it is not even worth asking and inviting the ensuing controversy, but it was a question that very much preoccupied old-school transgender healthcare providers. As I've mentioned before, the only criteria for me is whether the category is descriptive, and I firmly believe that AGP is very descriptive for many TiMs. I do not say this to pass judgment, merely to relate what I observe, and
what I observe in a non-professional and non-scientific context, to wit, online. Nonetheless, the current trans movement seems to be extremely tied to the online world.
Which brings us to the next interesting mental health question,
autism. Both TiMs and (perhaps especially) TiFs exhibit very high rates of autism-spectrum disorders. There is a disproportionate number of TiMs who fit a certain stereotype of thereof as well: working in tech or adjacent fields, successful (giving them disposable income for "transition"), but still socially stunted. Young TiFs, who once more I'm going to say I'll get to later, fit another: socially isolated, depressive, often concomitantly personality disordered. There are a lot of anime profile images in both groups. I don't say this in jest but rather to draw a picture in the reader's mind quickly. These are unscientific and stereotypical broad portraits, but nonetheless very real. What is scientifically undeniable however is that rates of autism are very high in both groups.
Why might that be? The following is mostly speculatory, but: Autism, as we know, is associated with very rigid thinking and with preoccupation with particular topics. It is easy to imagine an individual with autism developing a
preoccupation with gender especially if (via
rigid thinking) they feel they do not fit the mold. This is huge with TiFs. This is also a place where "social contagion" develops. This term, which is not meant to have negative connotation despite the word "contagion," denotes when through a set of behaviors, attitudes, and so on are spread between groups of individuals. It has been particularly studied in eating disorders and self-harm. Preoccupation with gender appears to be another socially-"contagious" issue, which leads to observable "clusters" of trans-identification which would be statistically more-or-less impossible.
They tend to go along these lines: one member of a friend group or student at a school "comes out" as transgender and is showered with attention. Perhaps there is even a speaker brought into discuss these issues. Rather quickly, a number of individuals "come out" as trans-identified at once, typically after spending a great deal of time looking up and discussing these issues online. This has been defined as "rapid-onset gender dysphoria" in an observational study (the only feasible kind) that came out in 2018 to a great deal of controversy from transgender rights activists. This was predictable: TRAs generally maintain that trans-identification is an essential, intrinsic and immutable part of "identity" and resist any attempt to discuss it from a medical, critical or observational context that does not admit this rather metaphysical paradigm to discussion.
So of the individuals described, who should be psychologically a "real" transgender? The controversy rages. People who we can all safely agree are
not "real transgenders" are psychotics who transiently have a delusion about their gender. This I've brought up before, but it's worth thinking about in contrast to examples like the ones above where transgenderism does not seem merely to be a matter of "gender dysphoria" related to "gender identity." Keep in mind that all the examples mentioned above will generally complain of "gender dysphoria" and report a trans-identified "gender identity."
This being a matter of subjective report, it is not easily argued with, but both AGP and ROGD individuals have been observed to discuss online about "gaming the system" and how to "pass" inventories and other psychological tests that are administered to them in order to access medical "transition," including passing around copies of the relevant tests. Jennifer Diane Reitz, a well-known Internet eccentric (to put it mildly) even registered
transsexual.org and put a self-created "test" there of highly dubious validity that tends to give people back the answer that they are, in fact, transsexual. This is no small problem as "transsexual.org" might be somewhere that a naïve person could navigate to expecting an objective test!
In short, I am glad I am not tasked with evaluating the suitability of trans-idenitifed persons! In fact, I am fairly certain that
lots of clinicians of all stripes are glad that they are not tasked with this. This probably plays no small role in the "informed consent" model for medical transition, which has become the preferred one in many cases. The inherent-ontological-identity concept of trans-identification suggests this model, too. The only thing the clinician need do here is ensure that the individual is neither completely insane nor physically unhealthy in ways that would contraindicate the medical interventions in question. I have laid out in broad strokes some of the major psychological issues that may be encountered but by no means all. In an "informed consent" clinic probably none of these would warrant attention.
You be the judge as to whether this is a problem, in each case. The biggest concern that I would have, particularly in the young, which I'll discuss more later on, is that these interventions cause life-long changes. Trans-identified females "transitioning" to male by taking testosterone, undergoing double mastectomy (increasingly popular) and perhaps genital surgery as well (not as popular but on the rise), particularly change their bodies in an immutable way. Changes in trans-identified males due to estrogen are less radical and less permanent and the "top" surgery (i.e. breast augmentation) is more easily reversible. (I've avoided talking about genital surgery so far but already see the point in this discussion where I will take it up.) So the question will be, to what extent do we owe it to patients who may
de-transition to "protect them from themselves?" And should the clinician consider any broader social issues beyond the individual patient? This was probably part of the motivation for excluding AGPs in early transsexual clinics.
This should be such a "no-brainer." It is incredible to me that the transgender movement has come to engulf children. That children sometimes express cross-sex identification or gender non-conformance (GNC) is not inherently surprising. A number of things can be at play here. Sometimes they're just kids, and kids go through phases. The TRAs will howl in response that trans-identification is an identity, not a "phase." However, longitudinally, among children who express trans-identification
(n.b.) to the point that it becomes clinically noticed, individuals who persist in this identification until adulthood are a
marked minority. To the tune of
less than a quarter of individuals. Young TiFs especially.
This alone should give serious pause to anyone wanting to give cross-sex hormones or surgery to GNC youth. ROGD-type "social contagion" can be an issue. What's more homosexuality or simple gender non-conformance (even in heterosexuals) can be "mistaken" as trans-identification, either internally by the child or externally (which would include the situations with conservative parents we have discussed.)
Also, there seem to be cases of parents who push this on their children. You mention children being put into drag shows, etc. For the sake of decency I will not mention names but there are some prominent Internet pesonalities that are known for this, who draw derision but also receive kudos from among the more radical gender activists. As to the parent who does this I suspect it is similar to Munchausen's by Proxy (MbP), a situation where a parent (usually the mother) deliberately induces illness in a child for "secondary gains" related to the medical system and the social attention that is paid to parents of sick children. This is a pattern that seems to show up in some situations here. These situations tend to be that of a natal boy and a mother who is highly involved in the "transition." One might speculate about the psychological motivations for this but we are already on fairly speculatory ground here so I will leave it at that and allow the reader to make their own psychological interpretation.
I want to stress that this is a minority. Most parents of trans-identifying children seem to be well-intentioned, if possibly confused. Many of them do not know what to make of the child's reports of "gender dysphoria" or a "gender identity" incongruent to natal sex. One hardly has to be a repressed conservative to not know what to think! Many very liberal and accepting parents wind up confused, too. The child (and now I am more moving our hypothetical into adolescence) may have already "came out" as same-sex attracted. The parents may have had no problem with this at all, or may have had questions then as well.
Regardless, it doesn't seem to matter. There is no roadmap for parents here. Unfortunately there is a lot of one-sided activism one can encounter online, though. A very disturbing phrase, or concept, that one encounters is "better a live daughter than a dead son," which touches on the elevated risk of suicidality in trans-identifying people in general, and especially youth. Various numbers have been floated about the percentage of such individuals with suicidal ideation or suicide attempts.
One prominent but flawed study claims that about 40% will make a serious attempt. Let's not debate details and agree that there is elevated risk in this population. Meanwhile, ROGD individuals in particular have been known to rapidly begin to complain of dysphoria even to the point of suicidality. Given some of what has been observed in these individuals as well as the likelihood of concomitant personality disorders it is almost certainly the case that some of this is conscious manipulation: encouragement to use such conscious manipulation has even been encountered in relevant online communities. (It's worth nothing here parenthetically that similarly flawed statistics are often circulated very dramatically regarding the
murder of trans-identified individuals. If one does the math it turns out that they are no more likely to fall victim than anyone else.)
Many of the effected children also seem to be on the autistic spectrum, something I touched on above. Especially in natal girls trauma and body image issues seem to be large issues as well. The ROGD scenarios are very vivid and very real and I would encourage interested parties to
read the paper in it's entirety. It is both illuminating and disturbing. It deals primarily with adolescents, which brings us to another issue: the physical changes of puberty are very often distressing, especially for girls. One can imagine this, in a heady mix of other factors like figuring out one's sexuality and being constantly exposed to explicit and often questionable material onlnie, contributing to feelings that can be read as "gender dysphoria."
So after all that, here we are, with a gender dysphoric young person. Perhaps none of the above applies and the case seems utterly non-pathological. There are plenty of these and I don't mean to imply elsewise. But
what do we do now?
It seems obvious that medications with lifetime effects and mutilating surgeries should be left to adulthood. Surgeries present their own issues: immature genitals cannot be rearranged to a satisfactory size, mastectomy is a problem before breasts are fully grown, etc., so usually, but not always, we are talking about cross-sex hormones. Keeping in mind that something like 80% of young people who express a trans-identity "desist" (or "detrans") it hardly seems rsponsible to do
any intervention, though.
Enter puberty blockers. In brief form the argument for their use is that puberty is even more distressing for a trans-identified young person than it is for their peers, and that "transition" is easier and the aesthetic results better (especially in natal males) if these changes never happen. Given that outright giving cross-sex hormones and surgery to youth is problematic, so this argument goes, we can give ourselves a couple of years for things to stabilize by chemically avoiding puberty, and then let the situation be revisited, and "transition" intervention given if needed.
A few different drugs are used for this, of a somewhat diverse nature, which deal with gonadotropin relaseing hormone (GnRH.) I won't get into pharmacology and endocrinology here, although it's interesting, other than to say in brief than GnRH does what it sounds like it does: releases hormones which, in a cascading effect via intermediaries, follicle-stimulating hormone (FSH) and leutinizing hormone (LH), wind up releasing the sex hormones we are all familiar with: testosterone, estradiol and friends. It's rather complicated but in essence it is a continuous cycle that is going on modulating the release of these various hormones which in turn deals with sexual development during adolescence, menses in females, and many, many other things. Puberty blockers interrupt this process, some in different ways:
Lupron (leuprolein) is one of the most popularly prescribed and it acts, essentially and putting it in terms Bluelighters will know, by artificially jacking up the body's tolerance to LH, resulting in inhibiting effects downstream. Others operate in slightly different ways but we will generalize here. Lupron is also used in various cancers, precocious puberty, uterine fibroids, and a few other things, on and off-label. It is notably used in the "chemical castration" of sex offenders, something which I have a little knowledge of professionally, enough to say that the evidence for it is not all there, especially in the more characteriologically disordered offenders and the more intransigent pedophiles. It is not given lightly in these situations as it is known to cause bone loss and osteoporosis, something which has lead to lawsuits.
All of us (male or female) have both T and E circulating in our bodies and they are essential for our everyday functioning. Interrupting this will unsurprisingly have consequences for primary and secondary sexual organs, muscle growth, red blood cell generation, mood, sleep cycle, etc. Obviously puberty blockers don't outright block both T and E, but it is worth noting what we are meddling with. As far as puberty blockers the focus is on "delaying" normal development which occurs as a spike in hormones mediated by GnRH hits during adolescence. Again, I'm grossly oversimplfying.
The thing is,
we have no idea of the long-term consequences. There is not even good data as to what "delayed" puberty catching up would look like. The drugs used as "puberty blockers" are used in
precocious puberty, which is what it sounds like, occuring at very early ages and obviously problematic physically and socially. In these cases they seem to do what they are supposed to and cause little harm. We simply don't have that data in terms of their usage with older children and adolescence.
The most well-established side effect of Lupron is inhibited bone growth but as to further possible problems, we simply don't know, and it is entirely reasonable to suspect that there may be some down the road, especially long term. After all, we are seriously disrupting an essential system at an essential time. Most knowledge we have on Lupron is from (mostly male...once again) cancer patients. This is an entirely different population, at a different developmental stage, and with a much shorter lifespan for longer term side effects to potentially emerge.
TRAs will tell you that puberty blockers are harmless.
This statement is unbelievably irresponsible, in light of what we don't know. In terms of psychological consequences, one can only speculate. There
is research, a number of studies of varying quality on varying types and sizes of samples, that suggests that puberty blockers decrease gender dysphoria-related mental health issues during adolescence. Leaving aside methodological difficulties, it being very hard to study this, it's not difficult to accept the fact that this may be true. Puberty after all causes a lot of distress and this may be not a small part of what is causing acute disturbance related or attributed to gender dysphoria.
Nonetheless, "delaying" puberty while one's peers are going through it, can be presumed to have some psychological sequlae. On the more esoteric side, it would be interesting to know from a psychodynamic perspective what this means for normal growth and parent-child relations. But much more down to earth, it's got to have effects. One thing it will
definitely do is mark the child out for special attention. As being identified as "trans" and all the more so as "transitioning" will do to begin with. This special attention, adulation even, that is heaped on young people from an early age due to their identification, is not to be overlooked even in young people not undergoing intervention.
If you've made it this far, congratulations. I have at least one more very long post to make, but it's not going to be tonight.
Hey Priest I am glad you made it into this convo. I was thinking of asking your perspective here in fact. I am always interested to know what regular gays and lesbians think about the trans issue as quite a few of them are more than a little skeptical. The most striking thing for me has always been about trans-identified individuals who are attracted to the opposite of their natal sex (i.e. who from the perspective of their identification are
same-sex attracted) who pursue partners who identify as "cis" and homosexual.
This particularly gets a lot of attention between gynephilic (especially AGP) TiMs and natal female lesbians (see: "the cotton ceiling.") Many lesbians have expressed feeling deeply uncomfortable, even unsafe, and, especially in quite young "LGBTQ+" circles, feeling pressure to have sex with individuals with natal males, even ones with intact penises. This always disturbed me. It's happening with gay men and TiFs too, or so I gather, you could presumably speak to it better, but an interesting pattern emerges: natal males pressuring natal females, creating problematic situations. Natal females pressuring natal males, doesn't really get much attention or have the same ring to it, does it?
LMAO yes. I don't even know what to say when celebrities make the news for "coming out as queer" and show no apparent divergence from normative heterosexuality expect maybe a flair for the GNC which may have been something to write home about 30 years ago but is now old hat.
(graphic descriptions follow)
I'm amazed by the number of people who speak as if a "neovagina" constructed via penile inversion (or other such technique) is
in any way functionally equivalent to a vagina. Aesthetically, even the vary best can be readily distinguished by anyone who's seen a couple vaginas in life. Sorry to say it. This is just the hard truth. Functionally, and without getting too graphic, they need a lot of maintenance or else they will close through natural healing processes (they are not, as they are sometimes referred to as a bit of a slur, "wounds," but they have much in common with wounds physiologically.) They have trouble accomodating, depending on the technique and the anatomy of the male body that the process started with, average to larger-sized penises. They do not stretch very much to accomodate being penterated, unlike a natal woman's vagina, and they come to a rather abrupt terminus.
Perhaps most importantly, the amount of sexual pleasure that their owners can derive from them is limited, sometimes none. Penile tissue is used which is supposed to be sensitive but this is hit-or-miss and certainly there is nothing remotely resembling a clitoris. Given all this it is not at all surprising why some would prefer to keep their penis, faced with the possibility of losing out on a lot of sexual pleasure. Of course, for some AGPs, the sexual pleasure is in
undergoing the process itself and in the fact of being penetrated, even absent any physilogical response as such, even through an artifical orifice.
Surgically constructed FtM penises or "neophallus" aren't terribly impressive either. A sort of "tube" is made of flesh from the leg or arm, and it is attempted to be attached to clitoral tissue. Success here apparently isn't that great either. Many will also report reduced sexual pleasure (although a significant number of FtMs will have had "issues" about penetration so this may not be that much of an issue for them.) As for dealing with "erections," techinques vary, but one popular one is to have a sort of pump in one of the testicles that inflates a tube through the neophallus. Again sensation will be limited. I would imagine being penetrated with one is rather different than with a natal man's penis as well.
For both FtM and MtF it will often take a particularly accomodating partner not only to get involved in the first place (first hurdle) but if post-op to deal with the related intimacy issues. Both groups of course complain of "chasers" ("gynandromorphiliacs") who seek out transsexual individuals to fulfill a sexual fetish. Pre-op FtMs have also been known to complain of heterosexual men who just view them as available female bodies.
I am not linking to pictures of any of this but they are easily found online, both "good" results advertised by surgeons and "bad" results displayed in either dissatisfaction or mockery.
