…I approach this topic with a wrenching awareness of what it feels like to be disconnected from your body, to hate with every fiber of your being the way you look in the mirror, and to be willing to undergo great feats of self-mutilation to achieve a vision that is always just out of grasp. My perspective on the matter, however, probably would not go over well among most LGBTQ individuals. As a person who has struggled with anorexia nervosa since puberty, the transgender anguish resonates with me. The similarities between the two illnesses are striking. Yet one is an identity, and the other is a disorder. Why?
At the heart of gender dysphoria is a paradoxical desire to be characterized as something one simultaneously declares is ineffable (i.e. gender roles are illusory cultural constructs, but I yearn to concretely embody that illusion). The contradictory desire in transgenderism is similar in hopelessness as the desire in anorexia. The goal is to be thin, and one is never thin enough until one is dead. The goal is to be a sex other than one’s biological makeup, and one cannot alter one’s chromosomes and genetic makeup.
If a man wants to wear makeup, dresses, even get breast implants, who are we to stop him? … But language policing, the implication that by misusing a pronoun we are savaging a person’s very core, is untenable. Using “he” instead of “she” may very well hurt someone’s feelings, but that is a level of sensitivity on par with agoraphobia (fear of crowded or enclosed public spaces). The onus is on the person to find ways of coping. The world cannot be responsible for validating a confusing, opaque issue that has been too quickly transferred from “disorder” to “condition,” from irrational to heroic.
An All-Consuming Desire to Alter One’s Self
Advocates insist that gender dysphoria is not a pathology. The World Professional Association for Transgender Health (WPATH) describes a disorder as “a description of something with which a person might struggle, not a description of the person or the person’s identity.” This is an absurd string of verbiage. A person’s identity is not his or her biological sex. That is part of a person’s identity.
However, many individuals with gender dysphoria feel they must try to change their outward appearance to match this inner ideal. Due to the physiological makeup of the human body, however, this attempt is often a mighty undertaking. One may even go so far as to say it’s a struggle. The intensity of this all-consuming desire to alter one’s self is what I find most similar to my own illness. We cannot rest until the outside matches the inside.
Many individuals with eating disorders assume an identity centered completely on that disorder. According to an article on the Social Issues Research Centre website, pro-anorexia websites espouse starvation as “the right lifestyle choice for them, and will allow them to achieve happiness and perfection.” Imagine if someone with crippling obsessive-compulsive disorder about germs could impose his beliefs. We’d be obligated to all carry gloves and wear face masks.
The same could be said for a chronically depressed exhibitionist. Accommodation and what is essentially encouraging a delusion is bound to “improve” the life of an individual who has felt like an alien in her own body for years. Unfortunately social support will never change the basic biological facts. Clinging to an illusion does not make a person crazy, marginalized, or inferior. It makes him human.
Remember Your Descartes? Feelings Aren’t Reliable
We cannot rely on our “feelings,” as strong as they are. If I relied on my feelings, I’d be dead. Why? Because my feelings tell me that eating food means gaining weight, and gaining weight is intolerable. Transgender children are apparently absolutely sure they were born in the wrong body. It is a belief held so deeply that we throw out all the entrenched knowledge of psychology and mental illness to appease it.
People with anorexia can often trace their discomfort with their own bodies back to early childhood, as well. Both situations are abstract feelings that clearly contradict reality. The certainty that one is a woman despite being born a man sounds awfully similar to the conviction that one’s body is overweight even when body-mass index is at starvation levels. The feeling of hunger—the most primal, ingrained of physiological response—impels the individual to abstain. Can you question the depth of that belief?
No one with any understanding of the matter is denying that a mismatch exists between the person’s brain and her body. The approach to “wellness” however, is hopelessly backward. The brain is the component of this puzzle with the capacity for immense plasticity. Noninvasive reconditioning occurs every day. The body is the factor that is hardest to alter in any meaningful way. So why are sex-reassignment surgeries the gold-standard treatment method in gender dysphoria literature? Why is such a drastic, violent procedure championed so fiercely?
The question is not whether someone’s identity should be validated, but whether the validation should accompany an attempt to fabricate an impossible artifice. If a man feels he is a woman on the inside, this begs the question: What is a woman? The unswervingly nebulous explanations that abound in defense of transgender rights echo the desperate bravado of the pro-ana crowd.
Adults have the right to dress, act, and live however they damn well please. But the swiftness with which the transgender “condition” has been accepted as mentally healthy is unfair to both the public at large and the individuals themselves. There are no 100 percent effective treatments for anorexia nervosa, but that doesn’t mean that’s how my mind is supposed to work and I should embrace it. The same should apply to gender dysphoria.
John Hopkins Psychiatrist:
Sex Change ‘Biologically Impossible’
Dr. Paul R. McHugh, the former psychiatrist-in-chief for Johns Hopkins Hospital and its current Distinguished Service Professor of Psychiatry, said that transgenderism is a “mental disorder” that merits treatment, that sex change is “biologically impossible,” and that people who promote sexual reassignment surgery are collaborating with and promoting a mental disorder.
Dr. McHugh, the author of six books and at least 125 peer-reviewed medical articles, made his remarks in a recent commentary in the Wall Street Journal, where he explained that transgender surgery is not the solution for people who suffer a “disorder of ‘assumption’” – the notion that their maleness or femaleness is different than what nature assigned to them biologically.
He also reported on a new study showing that the suicide rate among transgendered people who had reassignment surgery is 20 times higher than the suicide rate among non-transgender people. Dr. McHugh further noted studies from Vanderbilt University and London’s Portman Clinic of children who had expressed transgender feelings but for whom, over time, 70%-80% “spontaneously lost those feelings.”
While the Obama administration, Hollywood, and major media such as Time magazine promote transgenderism as normal, said Dr. McHugh, these “policy makers and the media are doing no favors either to the public or the transgendered by treating their confusions as a right in need of defending rather than as a mental disorder that deserves understanding, treatment and prevention.”
“This intensely felt sense of being transgendered constitutes a mental disorder in two respects. The first is that the idea of sex misalignment is simply mistaken – it does not correspond with physical reality. The second is that it can lead to grim psychological outcomes.”
The transgendered person’s disorder, said Dr. McHugh, is in the person’s “assumption” that they are different than the physical reality of their body, their maleness or femaleness, as assigned by nature. It is a disorder similar to a “dangerously thin” person suffering anorexia who looks in the mirror and thinks they are “overweight,” said McHugh.
This assumption, that one’s gender is only in the mind regardless of anatomical reality, has led some transgendered people to push for social acceptance and affirmation of their own subjective “personal truth,” said Dr. McHugh. As a result, some states – California, New Jersey, and Massachusetts – have passed laws barring psychiatrists, “even with parental permission, from striving to restore natural gender feelings to a transgender minor,” he said.
The pro-transgender advocates do not want to know, said McHugh, that studies show between 70% and 80% of children who express transgender feelings “spontaneously lose those feelings” over time. Also, for those who had sexual reassignment surgery, most said they were “satisfied” with the operation “but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery.”
“And so at Hopkins we stopped doing sex-reassignment surgery, since producing a ‘satisfied’ but still troubled patient seemed an inadequate reason for surgically amputating normal organs,” said Dr. McHugh.
The former Johns Hopkins chief of psychiatry also warned against enabling or encouraging certain subgroups of the transgendered, such as young people “susceptible to suggestion from ‘everything is normal’ sex education,” and the schools’ “diversity counselors” who, like “cult leaders,” may “encourage these young people to distance themselves from their families and offer advice on rebutting arguments against having transgender surgery.”
Dr. McHugh also reported that there are “misguided doctors” who, working with very young children who seem to imitate the opposite sex, will administer “puberty-delaying hormones to render later sex-change surgeries less onerous – even though the drugs stunt the children’s growth and risk causing sterility.”
Such action comes “close to child abuse,” said Dr. McHugh, given that close to 80% of those kids will “abandon their confusion and grow naturally into adult life if untreated ….”
“’Sex change’ is biologically impossible,” said McHugh. “People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.”