Doesn't self-ID only benefit non-genuine cases?

[UpfieldHatesWomen]

I'm trying to figure out if there are actually any benefits to self-ID at all for people with gender dysphoria. The arguments for self-ID are that it costs money, and it's 'humiliating' to have to present your case to a panel of experts. First of all, a GRC only costs £140. Doesn't seem like a staggering amount of money, if you follow the narrative that people will kill themselves in their masses without it. Are there other costs that I'm missing here? The NHS covers hormones and medical procedures in the UK. I also fail to see what's humiliating about a psychological/medical assessment, to see if you actually have gender dysphoria or whether you have a sissification/autogynephelia fetish. Unless, of course, you're never going to get a diagnosis of gender dysphoria, because you don't have it and simply get off on invading women's privacy/have a fetish etc. Self-ID benefits those who want to keep their penis - but if you have gender dysphoria, why would you want to keep your penis? TV propaganda such as the ITV series 'Butterfly' would have us believe that those with gender dysphoria hate their genitals so much they'll try to cut them off with pieces of broken glass. It seems like self-ID only benefits fetishists and misogynists, so why are politicians never challenged on how exactly self-ID is supposed to benefit transgender people, why are they so insistent on self-ID as the only possible route to trans rights? Are they just woefully ignorant about autogynephelia/transvestism/sissification etc? These fetishes are as old as the hills, why is everyone pretending they suddenly don't exist? Or for that matter, pretending that predatory men don't exist? Female politicians are subjected to the very worst kinds of misogyny on social media, so how can they be so incredibly naive about how misogynistic men and opportunists will use self-ID as a vendetta against women? It doesn't seem that self-ID actually help genuine cases, only those who would normally be refused a GRC because they have shown they're insincere/have other mental health problems/trolling etc.

My patient has been the way they are for some time now.

He tells me that they are very much in the minority amongst trans men.

A growing minority.

GPs dont diagnose anyone with that. We don't have the expertise. We might say there is evidence of that but we don't make a definitive diagnosis.

GPs are required to identify possible concerns re co-morbidities & refer appropriately when a patient presents with "gender dysphoria issues" prior to referral to GIDS.

see appendix A
www.england.nhs.uk/wp-content/uploads/2019/07/service-specification-gender-dysphoria-services-non-surgical-june-2019.pdf

January 2020 Marcus Evans
'Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just ‘Affirmation’ and Drugs'
(extract)
"We do not fully understand what is going on in this complex area, and it is essential to examine the phenomenon systematically and objectively. But this has become difficult in the current environment, as debate is continually being closed down amidst accusations of transphobia. As I argued in a May, 2019 presentation before the House of Lords, this de facto censorship regime is harming children.

Those who advocate an unquestioning “affirmation”-based approach to trans-identified children often will claim that any delay or hesitation in assisting a child’s desired gender transition may cause irreparable psychological harm, and possibly even lead to suicide. They also typically will cite research purporting to prove that a child who transitions can expect higher levels of psychological health and life satisfaction. None of these claims align substantially with any robust data or studies in this area. Nor do they align with the cases I have encountered over decades as a psychotherapist.

During the 1980s, I assessed adult parasuicides (apparent suicide attempts, or suicidal gestures). A number of my patients had gone through gender-reassignment surgery, and often were angry at the loss of their biological sexual functioning. They also were aggrieved with psychiatric professionals, who, they believed, had failed to adequately investigate the underlying psychological difficulties associated with gender dysphoria.

As a psychotherapist, I consulted with various mental health services that managed patients exhibiting challenging behaviours. In this capacity, I observed that patients who had a history of serious and enduring mental illness or personality disorder sometimes would also develop gender dysphoria. A common theme in their presentations was the belief that physical treatments would remove or resolve aspects of themselves that caused them psychic pain. When such medical interventions failed to remove their psychological problems, the disappointment could lead to an escalation of self-harm and suicidal ideation, as resentment and hatred toward themselves was acted out in relation to their bodies." (continues)
quillette.com/2020/01/17/why-i-resigned-from-tavistock-trans-identified-children-need-therapy-not-just-affirmation-and-drugs/

GEEpEe

Can you explain what being trans is as you understand it? You've said it's not to do with stereotypes around presentation or interests, but what is it? A woman can look like a woman with stereotypically female interests but be a man in her head. How does that come about?

What is a gender identity and what purpose does it serve to have one? It does appear to make those who have one unhappy and confused. Why not do away with the concept?

17/2/2020
Article by 'women experts working in the field.'

"Notes to the reader:

We write this as experienced clinicians who have worked in the sole NHS clinic for children and adolescents presenting with distress around their gender identity and their sexed bodies."

'The "Natal Female" Question'

(extract)
In summary, in the clinic we witness this toxic collision of factors: a world telling these children they are ‘wrong’; they are not doing girlhood (or boyhood) correctly. They realise their nascent sexual desire is going to be problematic; they struggle in puberty because it is uncomfortable, weird and unpredictable (particularly heightened if they happen to be on the autistic spectrum).

In all of our good-willed attempts to be empathetic, to share the pain of these very young people, we adults must not lose sight of the risk of joining too closely with them. Their pain is real, their way of making sense of it may be helpful, but it may not. Adults and professionals have a duty to step back from the feelings, whether their own or the young people’s, in order to consider what is fundamentally in young people’s interests. Listening can occur at many levels. We can hear and respond to distress without agreeing with the other person’s explanation of why they are experiencing it.

The significant treatment decisions being made are adult decisions. It is simply not possible for a child or adolescent to conceptualise a loss of fertility or sexual pleasure before they have developed their adult body.

We are dealing with strongly held beliefs and associated feelings. On the one hand is a novel belief that we are all born with an innate ‘gender identity’ but sometimes, tragically, for some trans people they are born into a sexed body that is misaligned from that gender identity. From this perspective, the problem is a tragedy of birth, as with other genetic or physical difficulties. From this position it would seem and feel as though the only sane and morally congruent thing to do is to speed up access to medical treatments. After all, if this is a medical/physical problem then, of course, a medical/physical solution will be most apt. Why would you want to hold a person back from that? However, even if this were true, there would still be many questions about the long-term trade offs of pre and post puberty ‘gender affirmation’, and different regimens and operations. Ethics would still demand high quality research into the size of harms and benefits of major medical interventions on a healthy body for a psychological indication.

On the other hand is the belief that no one has a gender identity that is discrete and separate from the rest of their identity/personality. The body we are born into is, therefore, just that. People with gender dysphoria usually exist within a healthy body, regardless of how they feel about it. From this position, the gender identity, however conceptualised, must have been formed through the developmental processes that the young person has undergone. If we believe this, then the only sane and morally congruent way to alleviate the distress is to explore their past and ongoing developmental processes in order to help them make sense of, and influence, their distressing feelings. We would consider the use of therapy to help alleviate this distress as virtually mandatory, as this is what we usually apply to distress. From this position. it would be unethical to intervene at the level of the physical body at all, as this is not the problematic feature." (continues)

womansplaceuk.org/2020/02/17/the-natal-female-question/

And

Can I divert the thread a little to say thank you to some of the regulars here like crone and rowan who have helped me understand myself better, helped me feel less at war with myself. It's all ok, however you are. Not everything needs to be a statement. When I started reading this board, I had huge recurrence of childhood nightmares, as things got worked through in my head.

It's all ok, however you are.

midge
I've learned a lot from your posts, thank you.
A lot of us are re-processing & healing from childhood harms.

I trust that professionals have enough evidence to make good decisions

Despite the wholesale resignations from the Tavistock and the current court case against them for lack of professionalism and for processing children down an almost inevitably medicalised pathway far too fast? I really think some critical thinking would be in order here.

As I say, I don’t have the answers but I worked out something odd was going on and started doing some research.

Can you imagine if one of you approached me wanting referral for tubal ligation because you're finished with pregnancies and I refuse because I believe you'll end up with a permanent change that you'll phase out of?

I have experienced this, as have many other women.

1. Increasingly these days, women wanting tubals after completing their fanilies are instead fitted with mirena coils as they are cheaper, safer, less invasive, and reversible.
2. I decided at age 13 that zero pregnancies was enough for me. Over 25 years later, despite asking many GPs, there is still no GP who will refer me for a tubal.

Non-reproductive examples:

1. My employer's OH assessor, who is a qualified GP, suggested topirimate as migraine prophylaxis. My own GP refused it, giving pizotifen instead.
2. I have a prolapsed disk, causing sciatica. My GP won't refer me for diskectomy because there's a risk that the surgery will make the sciatica worse.

In my experience, GPs often outright decline a treatment or offer something different. I'm OK with this because I don't regard my GP as a shop assistant providing whatever I demand, but instead I see her as a skilled professional balancing benefits against risks and balancing my needs against the needs of everyone else using our underfunded NHS.

Again, I see the trans lobby demanding "rights" that mean them being treated radically differently from everyone else. This is now a pattern, I can no longer disregard it as a series of coincidences.

Many people who request tubal ligation already have the coil or dont want it for good reason. It would be completely infantilising for me to do anything other than check they are aware of all options. Trying to then persuade someone to do something they feel will be inadequate for their needs is wholly inappropriate.

It sounds like you've become accustomed to shoddy care and don't know any different.

Either way, what you're all doing here by trying to persuade a GP to block referral to a specialist and convince a trans person they are not trans and do not need to transition would be completely unprofessional and I would never treat any patient in that way.

Most patients who come about something huge like this will have researched everything beforehand.

In other words it's OK for patients with a mental health problem to self diagnose and decide on what treatment they need, even though the essence of mental health problems is disordered thinking.

GEEpEe I have some sympathy for you, because I've heard young women complain about not being referred for sterilisation and find it insulting that they are treated as though they don't know their own minds. You are therefore in a very difficult position.
Regarding transition though, you say patients will have researched beforehand, but isn't that part of the problem? Gender identity is a phenomenon of the internet, based in an ideology, rather than simply being a medical condition. I don't doubt that there would always have been some trans people in society, but the phenomenon of ROGD cannot be ignored. 20 years ago, teenage girls experienced exactly the same issues with discomfort over their developing bodies and gendered roles, I for one remember it all too well, and definitely would have considered 'transition' if it was something I'd known about back then. But transition is man made process created through the application of politicised theories that have gained prominence in recent years, not simply a 'cure' for an illness. It is a cultural movement with ideological beliefs behind it, the unscientific idea of gendered souls.This is the problem, as a GP, your treatment of your transgender patients is therefore a political act. I'm not telling you that you should put obstacles in your patient's way, but you cannot ignore the political aspect of this. You are clearly aware that patients learn scripts from the internet so they can say what they need to say to get the treatments they want.

by trying to persuade a GP to block referral to a specialist and convince a trans person

For the THIRD time. No one is trying to get you ‘block referral’ just to have a more accurate picture about what happens next.

There are NO services for detransitioners and odds on, you will have one as a patient in the next 5 years.

WAKE UP MAN!

I read recently a news story of a trans woman who is suing their healthcare provider (I think it was in Holland - can’t find it) because they now want to be a parent (well technically a father) but can’t because of the medical treatment the must have known the needed previously.

Most patients who come about something huge like this will have researched everything beforehand.

It depends what you consider "research". If you mean Twitter and r/asktransgender then yes.

Research my bahookie. Twitter and chat groups (and lobbyists) isn’t research. Besides - my kid can ‘do his research‘ and not actually grasp the main issues.

@Ereshkigalangcleg

No I understand that's where you get your research from but most patients really do source quality information. Sometimes outdated but perfectly robust research at the time.

Surely they find the research that supports their existing thoughts/wants?

I provide various accounts of trans people and/or their families using the NHS for harm caused from NOT referring and attempting some bullshit conversion techniques to talk them out of it.

The people who research gender identity do so because of their dysphoria. In fact, many people who feel this way initially aim to feel more comfortable with the anatomy they have because of the risks of surgery. Many trans men opt not to have bottom surgery because of the risks especially around sexual function. Surgery for trans women in that respect seems to retain more sexual function and pleasure.

I understand that you all have your concerns about gender identity and how it may infringe on hard earned women's rights but this route of trying to prevent people with gender identity issues from seeking help because they might eventually physically transition isn't going to cut it because it is essentially treating trans people how we treat women in regards to women's health. That is something we are trying to eradicate because it's been found to lead to premature death, especially in poor and BAME women whose medical symptoms are often dismissed as psychosomatic or psychological.

The prison thing is far more valid and supported by research. The research needed to counteract your concerns about prisons isn't available but is in process but results won't come for years. That research is to compare the rates of violence of trans women compared to cis men and work out what risk factors make a trans woman more likely to commit violent crime at similar rates to cis men. A hypothesis exists that prolonged exposure to male socialisation (which an adult male prisoner who wishes to transition would experience) would mean a risk of violence comparable to a cis man. In the absence of research, you could promote erring on the side of caution. That sounds far more sensible than advising GPs to obstruct access to specialists and discourage transitioning.

Still reading TFT but ...

People who call for self-ID are calling for a unique level of trust for one group, that we do not extend to any other group in our society, however vulnerable.

Guess why.

///: This, x 1000. I read a post on FWR a couple of years ago from a transwoman who was very against self ID (apologies I can't remember name) who said any individual who wanted something as extraordinary as to be recognised as the opposite sex, which is inevitably going to affect others you need to be prepared to demonstrate the sincerity of your conviction. Otherwise it isn't actually sincere and does not deserve others to change their world to accommodate yours.

I think this is very true.

but this route of trying to prevent people with gender identity issues from seeking help because they might eventually physically transition isn't going to cut it

For the FOURTH time that is not what we are saying. Fuck me, your listening and comprehension skills are shit. Can’t believe you are a GP.

In fact, I suspect you are just larping as one.

attempting some bullshit conversion techniques to talk them out of it.

Hmm, describing alternative paths as conversion therapy sounds like an ideological stance not an evidence-based one.

GEEpEe using the word "cis" suggests someone fully committed to gender ideology in fact. I suspected it from his other posts
Now he's tipped his hand. Hardly an impartial observer there eh?

GEEpEe some people do their research due to dysphoria, others because they have other mental health issues or autism and are struggling in other areas - don't you think it's important to determine which is which? You seem to be taking people at face value, I can't believe that this would be the attitude of a GP. Also, please do not insult women by conflating women not being listened to about their ailments with trans people presenting at your surgery and having to be assessed. My previous post points out why this is not the same thing, trans identity is now a cultural and political movement, even a fashion. I'm finding hard to believe you are actually a GP, no GP I have ever met has had such a naive attitude.