Yesterday I got round to a browser tab I’d been saving for a week or so. It felt like it needed time, and I’m glad. It was a survey by Loughborough University on the revised ICD-11 diagnostic criteria, very thorough and thought-provoking, and took two hours. It was all about the terms and words used to treat gender dysphoria (in current nomenclature), and whether ‘gender incongruence’ is better or worse. And about whether a clinical diagnosis is relevant, necessary, and if it should be classed as psychological. All this, divided by under-12 children, adolescents 12-15, and adults.
Writes
I had by this time also expressed another niggle on Facebook about gender recognition (the Act, Panel, and Certificate), because last Friday the Gender Recognition Panel met with my papers in hand, to decide whether I met the criteria of being a woman. I shall know in the next few weeks. I’ve written previously about the indignity of this, not least because my gender is of no consequence to anyone else but me, let alone a subject to be policed by people with no experience of gender dissonance, dysphoria or incongruence. And at my expense. I have also signed up for another survey, on my experience of the impact of the Gender Recognition Act. It has all been on my mind recently, since the Act contains unfairness, injustice, verbosity and bureaucracy.
It also came at a time that a news story has been circulating in print and on UK morning TV, about someone detransitioning. The media coverage has been bad, in terms of sensationalism, gross inaccuracy, misleading information, and undermining the 99 per cent successful outcomes of gender treatment. Here, a man (who still says on TV ‘I am a woman’) says it has been too difficult (after 10 years) to live as a woman. Their treatment has been testosterone-blockers and oestrogen, coupled with breast augmentation (reported – I guess wildly exaggerated – as FF). Their treatment was described as costing £10,000 (‘of taxpayers’ money’), which is the standard figure quoted for genital reconstruction surgery, despite this surgery never having taken place. Media preference for inventing a good story aside, this person had a choice, and still does. There is nothing disgraceful or sensational about that. This, to me is just a marker of being gender queer, not gender dysphoric in the more common binary sense. It’s a bit like a prominent lesbian writer who has recently said that she chose to be lesbian. That to me is a clear marker of being bisexual. Where there is choice, even where there is preference, there are people who fall outside the binary view. Surprise, surprise! The binary is an invention of a simplistic world that does not encompass the breadth of human experience.
The point, however, is that all this writing (yes, like this blog) is but one viewpoint, given an appearance of authority by the media. The detransitioner urged massively more psychological screening at gender clinics, which might drive more to suicide than it would save. Let’s hear more from those whose lives are saved than the tiny minority who feel the need to blame someone else for their decision.
Rights
And so, on several fronts, there is this big issue: who decides on another person’s gender, on which criteria, and what should be the rite of passage from their former opinion (at birth: this is a boy/girl) to their revised opinion (we formally accept that we were mistaken at birth)?
To say that it matters to anyone but the individual, is like saying there is a rule whereby a flower may not be described as purple, only as either dark red or blue. If the flower is happy to be regarded as one or the other by the observer’s definition, well and good. But if the flower is purple and regards itself on the blue end rather than red, or steadfastly says it is purple, why should it matter? Gender queer and bisexual exist, and we know what we are in ourselves anyway. Yes, really.
More than that, why is it in anyone’s gift to say that I am not a woman, female? All that exists of male in me is a skeleton that has a form directed by a small chemical during growth (testosterone), and a prostate (because the risk of removal is not worth it). I have yet to see a reason, based on equality of rights. The only arguments derive from male primacy in our culture, and that is not a right, it is a wrong.
The arguments people have tried on me against this view are all about deceit and disguise for the purposes of intrusion. Trans* people do not do this. Gender dysphoria is not a behaviour.
And so back to the business of diagnosis, terms and criteria.
I observed, in completing the survey comments, that the only task of a psychiatrist in the whole process of confirming that someone’s gender is not indicated accurately by their genitals, is to eliminate psychological indicators for anything else. The psychiatrist who finds nothing permits the diagnosis of a physiological problem. The dissonance (or incongruence, if you prefer) does not originate in the mind, but in physiological events that stimulated development of primary sexual characteristics at odds with the sense of self.
Once more: gender dysphoria is not a behaviour, and that is why I also baulk at the use of the term ‘transsexualism’ in the definitions of gender dysphoria. This is not about rights to do anything, it is about the right to be authentic.
When it comes to rights (maybe Rights) society has to recognise the way things really are, decide how to act on this, and ensure that treatment is fair and applied. The problem with the Gender Recognition Act, is that the importance of being ‘a man’ or ‘a woman’ has been over-emphasised. You must decide! And show such decisiveness that everyone knows unmistakeably what you are and why! Dear Ms God: Why? Can people not just ask each other and leave it at that?
Rites
Since we are all assigned a gender descriptor at birth (again, I can’t quite understand the necessity for this, unless we are destined to be treated differently) the first rite of gender is naming. After that we all have the right to write the name we want, and to have this changed officially and easily.
Over our first decade, we can experience a variety of feelings about whether we ‘feel like’ a boy or a girl. It isn’t just about toys or clothes, but where we belong. Being a tomboy, or a girly boy defines nothing either. But in ourselves we have feelings about where we do and do not belong, and sooner or later these settle.
Puberty isn’t exactly a rite of passage in Western Europe, but menstruation or a breaking voice are part of ‘becoming’ a man or a woman, and ambiguous, or non-happening aspects of puberty are troubling to parents and worrying to children. But for the trans* child, this is a rite of passage that terrifies. Who holds the rights now? Parents? Clinicians? Or the child themselves?
The problem with rites, formal or otherwise, is that they fix things that then have to be undone. The greatest favour an adult can do for a trans* child is to listen, believe and stop the clock. Delayed puberty is the least harmful outcome. So why do we so often hear an outcry about children being manipulated, with misunderstandings about treatment methods? Yes, we need proper diagnostic pathways and expert professionals, the right terminology for the most transparent description, and we need it not to sound trivial (I think ‘incongruence’ is), so that treatment is taken seriously.
The final rite we face in the UK, is the appeal under the Gender Recognition Act, to the Gender Recognition Panel, for a Gender Recognition Certificate. This enables a new, revised, correct, birth certificate to be created. Having had almost zero professional support for the past few years, my paperwork is presented as a testimony to endurance. I have no right, without scrutiny, to formally identify in my true gender. I can call myself what I like, write what I like, but officially, until I can prove and explain what I have done clinically and why, or what I have not done clinically and why (even though what I have done clinically, or not, does not affect the outcome of my application), I am still officially a man.
Tell me, as I write, is this rite right?
Summary
We still desperately need good writing, by diverse trans* people, to explain the reality of gender dysphoria, however we variously describe it. We need our rights to own our own gender without interference, suspicion and policing by people who have not lived this. And we might even benefit by better rites of passage than exhaustive documentation of how we have survived transition with very little support or help, in an expensive plea to reverse that birth certificate bestowed on us with so little thought or necessity, so long before.
And if you read the stories in the media about those of us who transition young, or old, or unwisely, or cheaply, or expensively – please remember that each of us is every bit as human and a person as you. We are not separate, or other, with fewer rights, or to be viewed as deceitful or fraudulent, or psychologically disordered.
No; just imagine that you are the one instead, who has to prove their case for their own sense of self, and buy a certificate to say they really are what they say they are. Right?