Why does UN say Gender Dysphoria NOT mental illness?

[Judder]

AFAIK the World Health Org changed the definition in the last year or so to say it isn't a mental illness. Does anyone with scientific or medical or psychiatric knowledge understand why the definition changed? If it's not a mental illness, what kind of condition is it classed as and why? I've tried looking into this but it all goes over my head. Or if this has been discussed and I missed it, please could some kind person post a link to that thread. Ta.

development of biological sex may not work properly on the brain, reproductive organs and genitals, causing differences between them.

Argh. It’s a sort of a waffly woolly statement that implies the person making it has v little understanding of genetics and development. It’s very michcthe hormone wash theory and there is nothing that backs this up. Sex is determined genetically - there’s a region on the Y chromosome called SRY (sex determining region of Y) which encodes a gene called Testis determining factor. That’s the top of a cascade of processes which control the Male developmental pathways. Some of those effects are mediated by hormones, many are not.

Sex of the embryo is determined at conception. Various things can go wrong, like all bits of development but the idea that you just splash a bit of testosterone around et voila is a gross simplification.

Also from the NHS website

Once you've completed your social gender role transition and you and your care team feels you're ready, you may decide to have surgery to permanently alter your sex.

The NHS thinks people can change sex.

Oh, Bowl, it's always so soothng to hear your dulcet tones full of facts and science after a long day at Twitter the coalface.

But in the meantime, can we do anything about what the NHS is putting on its website?

It's bollocks and they need telling it's bollocks.

They have a form for feedback about the website
www.nhs.uk/about-the-nhs-website/pages/feedback.aspx?itype=site

I am going completely bonkers. I haven't had broadband for weeks and weeks, which means my PC is currently useless. I'm used to writing and researching on my PC and feel very muted.

I should grateful for a phone and WiFi but I so miss having multiple tabs, the sheer space, being able to metaphorically whizz about...

Which little rant is sheer frustration at being disabled from blasting the NHS website in detail and at length. Communication about health issues is one of my skills.

Next week I hope to have the internet back in my office.

Are they reading the same papers as that fruitloop at the CERN conference?

Okay. Either I'm going bonkers (always a risk) or they've changed that advice. It is a lot more vague and flimsy now.

I remember reading reading the thing about receptors and trying to work out why trans people didn't get given more of the actual sex hormone that wasn't working properly. But apparently that doesn't work. I can't have imagined that surely....

Maybe it would be useful to focus efforts on lobbying the NHS (and the BBC) rather than Ocado from now on?
Not knocking the Ocado boycott, it's just that clarifying, and hopefully changing, these (shocking and unscientific) NHS statements would have much more impact. Where did they get these definitions from??? It's so flipping regressive.

This is interesting, from the WHO
icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f344733949

If I'm reading that correctly you're only categorised as trans if you have gender disphoria, so feel very uncomfortable with your primary sex organs. So all the trans umbrella "suck my lady d*cks " aren't valid.

icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f344733949

Not valid

(Sorry I am essentially recycling my post from the Biology is not Bigotry thread and www.mumsnet.com/Talk/womens_rights/3313537-Sex-vs-Gender-in-medicine-and-health-care , but here goes):

The NHS Is not giving people accurate health information because the TRA dogma must always be appeased.

So if you consider what is a vagina and what is a penis. What these organs are and what they can normally do. The physical systems that they are part of, which contribute to why they do what they can do. Keep that understanding in your mind.

Then look at the NHS Choices pages on gender dysphoria:
www.nhs.uk/conditions/gender-dysphoria/treatment/

If you scroll right down to the section about biologically male adults having surgery, it says: eg

The vagina is usually created and lined with skin from the penis, with tissue from the scrotum (the sack that holds the testes) used to create the labia. The urethra (urine tube) is shortened and repositioned. In some cases, a piece of bowel may be used during a vaginoplasty if hormone therapy has caused the penis and scrotum to shrink a significant amount.

It continues that:

The aim of this type of surgery is to create a functioning vagina with an acceptable appearance and retained sexual sensation.

It goes on to say, equally untruthfully, that a ‘functioning penis’ can be made out of surgically altering a biologically female person’s body.

Note: this is my use of quotation marks, not that of the NHS. They don’t use quote marks to show that these surgeries create a ‘simulation of’ other organs- NHS Choices says you will get a functioning penis or functioning vagina. Except everyone knows that the results of these surgeries aren’t these organs, nor do they ever ‘function’ at all like naturally-occurring sex organs.

For example- The only ‘functioning’ the described surgically-created ‘vagina’ is capable of, that might be vaguely similar to a real vagina, is a capability of being penetrated.

But without any of the natural vaginal musculature or in physical structure, natural lubrication and protective flora or the similar level of physical sensation involved.

As if capacity for penetration was the only necessary activity or definitive ‘function’ of vaginas. It’s all so reductive about what female sex organs are for and can do.
It is also misleading people about what they will end up with, after having had hugely invasive permanent surgeries.

Why are people not being told the truth?

It honestly looks like they genuinely do not know what actually causes transexual people to feel the way they do.

So I guess they are putting trans in with sexual attractions because "we don't know why some people feel this way, but they do"
I don't think that's right personally.

Are other bodily dismorphias in the same category though? Anorexic people? Surely they should be all in the same bracket?

If trans isn't a mental health issue, many trans people seem to suffer with other actual conditions. (Yes, I know not all).

www.facebook.com/1841096309457396/posts/2222600117973678/

That Facebook thread is just a sample obviously but it highlights the struggle people are obviously having.

Coz hurty feelz...

If body dysmorphia is a mental illness then so should gender dysphoria.

of course it depends on how you define 'illness' but if a male believes he is actually a female even though his body is biologically male something aint right....

I guess maybe because illness suggests it should be treated/corrected and they want to steer away from that...

I guess maybe because illness suggests it should be treated/corrected and they want to steer away from that...

The argument seems to be that it is not a mental illness, so should not be treated as such, but it is a 'condition' which needs medical treatment to bring the body into line with the way the mind thinks it should be. That seems to be the transactivist line, anyway, and that seems to be where the NHS are getting their information from.

The rational way of thinking would be to put it in the same sort of category as body dysmorphia and anorexia, where people think there is something wrong with their perfectly healthy body. Rationality has no place in transgender ideology, though.

crone I meant treated as in, trans lobby wouldn't want a gender dysphoria to be treated with the aim of removing the dyspepsia, e.g. through some sort of therapy

obviously their solution us to treat the 'gender' bit by transitioning, not the dysphoria bit.

dyspepsia? dysphoria!

Sorry I can't quote you research or anything, but I thought it was a similar thought process which resulted in homosexuality being removed from DSM (Diagnostic and Statistical manual for mental health disorders) in the early 1970s

I read this paper published this year in Transgender Health medical publication which suggests that transgender is a somatic condition (caused by the body, not the mind) ... but it is very clear with its references and says there is no real evidence, this is just conjecture:

www.liebertpub.com/doi/full/10.1089/trgh.2017.0053

(The relevent section is title: Gender Development / Biological considerations.)

The NHS website too should be honest about the lack of evidence. It's just one hypothesis. I bet there are other theories (experts probably too scared to speak up, or not given grants for research).

In many ways the NHS are at the heart of all this. They are the ones calling us cervix havers and chest feeders and um bleeders or wotnot.

but I thought it was a similar thought process which resulted in homosexuality being removed from DSM (Diagnostic and Statistical manual for mental health disorders) in the early 1970s

The thing is though, being homosexual is seen across the animal kingdom and in all human societies at roughly the same level (although of course the ability to express this without harm has varied wildly throughout history.) being gay has a biological origin, it’s normal and it’s possibly even indirectly beneficial for reproductive fitness (there’s some hints that the siblings of Male homosexuals have greater reproductive fitness.) so there was NO biological or scientific justification for treating it as an abberation or mental illness.

There’s no such evidence for being trans.

www.nature.com/articles/s41598-017-17563-z

This is an interesting (and much quoted article by the TRAs). It has a small sample size but is peer reviewed.

It would be great to see a scientist's take on this, but it seems to me to be saying:

Lady and man brains sort of exist, with a sliding scale of gender.

Pre hormone (and post hormone) trans women have an area of their brains similar to vaguely lady brains. Suggesting this develops in the womb.

Although I don't understand how (given their sample only included trans women who'd been identifying as women from a very young age) this is definitely nature not nurture. You surely can't tell for sure until we can scan newborns. (Obviously impossible)

There's also stuff about depression effecting this part of the brain too.

This study only looked at trans women who were attracted to men. So if it's used to justify the cotton ceiling brigade that's incorrect. It's not about them.

They liken gender dysphoria to being gay. The logic is: Being gay is not a mental disorder, so why should being trans be?

Of course, this comparison is bollocks, because you can be happily gay without any need for medical intervention.

Then again, some 'transwomen' are happy without an intervention, a beard and a penis, so I guess, they really are not dysphoric. Personally, I'd still class their need for external validation regarding pronouns, a disregard often accompanied by hissy fits, as a mental condition. But I'm probably just not woke enought to understand the whole thing.

Regarding the Nature article, a couple of comments:

1. Furthermore, these alterations in the insula could be related to the neural network of body perception and reflect the distress that accompanies gender dysphoria. The hypothesis that insular volume variations in TW individuals reflect the distress of these individuals should be considered in future studies including large TW samples by evaluating significant correlations between GMV and symptom severity ratings.

This implies that they may be looking at what the gender dysphoria does to the brain, not at what brain structural difference causes dysphoria.

1. One important difference between our VBM study and the study performed by Savic and Arver (2011) is that the latter investigated non-androphilic TW (sexually attracted to females, both males and females, or neither gender)20 according to the Blanchard classification, which is based on the sex assigned at birth of TW44, while our study investigated androphilic TW (sexually attracted to males). Therefore, one might speculate that the differences observed in the insular cortex could be linked to the sexual orientation of TW. It should be noted, however, that sexual orientation and gender identity are distinct phenomena. For this reason, overlapping VBM findings associated with these two conditions are highly speculative. Another VBM study assessing hetero- and homosexual CM did not identify any regional GMV differences between groups. Homosexual CW presented lower GMV in the perirhinal cortex than heterosexual CW45. Considering these speculative findings, further MRI studies comparing androphilic TW with non-androphilic TW are required to reveal further information on this topic.

What they are saying is, hey, we did not control for homosexuality (do gay men have the same traits), but let's just act as if being gay and being a male trans attracted to males are in no way related (even though Blanchard, whom they cite, holds they are). We or someone else need to check for that next time (surprising flippancy for a NATURE paper. Peer reviewers usually don't let a lack of controls slide).

1. Please note, that Blanchards classification into Autogynephiles and homosexual Transwomen is the basis of several studies, the current one from 2018 being published in NATURE. And yet, TRAs will drone on about how Autogynephilia is a debunked theory (without being able to cite any peer reviewed study doing the debunking).

1. It is impossible to look at a brain and say it is male, female or trans. The differences reported are differences of features on average, with overlapping distribution curves.

I think old school transsexuals are right to be kicking off about the beardy gang.

I made a mistake with that article. They don't liken the transexual brain to a "ladies". They say it's different (in that small part) to natal women and natal men.

We know trans is a definite state of being, there are people that truly feel this way.

There's studies now which may link this difference to a genetic cause academic.oup.com/jcem/advance-article-abstract/doi/10.1210/jc.2018-01105/5104458?redirectedFrom=fulltext

I think this is all good. I think it is going to be crucial in determining who really should be given help to transition and who shouldn't. But they won't like that will they.