If someone identifies as an amputee they are given psychological help

[gardenbird48]

and steered away from modifying their body. They are not immediately affirmed, applauded by their friends and sent for surgery. BDD is the same.
I am really struggling with the difference between this and gender dysphoria, can anyone, esp with a psychiatry background explain please?

And I apologise for descending into "how they got like this" but I do think my example is a very good one of how these gender identities are actually no different than any other dissociative identity and certainly the advisable method of treatment as someone with those issues myself is NOT encouragement and throwing surgery at every demand.

@suggestionsplease1

No I think I didn't explain that well, I was clumsily trying to get across the difference between a hallucination and delusion. PP Theld has just explained the views on different beliefs much better than me. I was trying to say there can be some truth in situations without the eventual conclusion being correct.
I don't think I implied people with 'femaley' brains who feel female are delusional, but I was saying it could be argued that people with femaley brains who then attribute the experience this gives them to requiring physical correction of their body could be attributing a questionable belief to their situation.

Let me try and be clear on your questions about genitalia, are you asking if having male genitalia means it's inherently a false belief to believe you are female?

WokeUpSmeltTheCoffee

Body dysmorphic disorder, anorexia, being transgender all involve having false beliefs about your body (overvalued ideas technically)

I've wondered for a while if there is any link or overlap between dysmorphic conditions and fictitious disorder (aka munchausens).

To my mind there do seem to be parallels but that's just speaking as a lay person.

I definately think that in the case of trans kids it's more akin to munchausens by proxy where the parent wants the attention of having a trans kid.

[quote Broomfondle]@suggestionsplease1

No I think I didn't explain that well, I was clumsily trying to get across the difference between a hallucination and delusion. PP Theld has just explained the views on different beliefs much better than me. I was trying to say there can be some truth in situations without the eventual conclusion being correct.
I don't think I implied people with 'femaley' brains who feel female are delusional, but I was saying it could be argued that people with femaley brains who then attribute the experience this gives them to requiring physical correction of their body could be attributing a questionable belief to their situation.

Let me try and be clear on your questions about genitalia, are you asking if having male genitalia means it's inherently a false belief to believe you are female?[/quote]
I don't think I implied people with 'femaley' brains who feel female are delusional, but I was saying it could be argued that people with femaley brains who then attribute the experience this gives them to requiring physical correction of their body could be attributing a questionable belief to their situation.

Ok - I think I take this to mean that you feel they have come to a bad conclusion/ decision about how to manage their gender dysphoria, rather than that they are delusional?

And I don't know that I disagree with that for the most part, as I have said before, I am no outright proponent of sex reassignment surgery, but I do believe it is appropriate some of the time.

In answer to your last question... yes, I guess I am - but the question is complicated and posits that there may be differences in what your body genitalia are telling you and what your brain might be telling you.

So, at birth we humans categorise babies according to their visible genitalia, and most appear in a fairly binary fashion so this is quite neat to do.

I am surmising that brain biology may be at odds with their genitalia and that, if this was the case, would that child be considered delusional for feeling they are not the sex their visible genitalia tell them they are?

(Any yes, I acknowledge the complexities of this brain sex issue - I am not trying to oversimplify it, I will try to address that in another post)

@SapphosRock

Me too Jaxhog - nobody is suggesting religious people need psychiatric help for their beliefs so I don't see why transgender people do.

Hmmm but I'm not interested in trans adults. My skin in this game is the transing of children. Mainly because it could so easily have been me if I was a teen now. And that terrifies me on behalf of all children. So I believe that trans kids need help but not drugs or operations until they desist or become of age. As for adults, they can dress as they wish, have as many operations as they wish etc, but they are still not allowed in my toilet/prison/hospital ward etc.

@OldCrone

I think gender identity is a little more nuanced and complex than the single linear dimension of height which can be determined by a number alone!

A more detailed reply to this.

Suppose that there is some attribute of brains which is only ever found in female brains. By definition, this attribute, being exclusively female, will never be observed in male brains.

Now suppose that a man's brain is analysed, and he is found to have this attribute which it was thought was only ever present in women's brains. What this means is that the original assumption (that this attribute is exclusively found in female brains and never in male brains) was incorrect, and the attribute is actually found in both male and female brains, but is more commonly found in female brains. It doesn't mean that this man has a 'female' brain in his male body.

If there was a scietific test to determine whether a brain was male or female, it would actually prove that transgenderism doesn't exist in the sense of having a brain of the opposite sex to the body.

Well, as I've said before, I take no absolutist position on this - I don't believe in binary, distinct male and female brains.

But it is puzzling, isn't it? Why do these studies of trans people' brains tend to show structural and functional similarities to their preferred sex rather than their body sex? Why do you think this is happening?

The brain is so vastly complex that we really don't have a handle on this yet, and we may never do. But I don't think it's a simple question of one attribute.

If you were to say (and this would be an oversimplification, I am not laying claim to any figures) that there are 100,000 brain structures, and they all have different volumes or cortical thicknesses, and there are 100 billion neural networks, and they are all wired differently from person to person, and fire in different patterns, and then there are several different hormones as well, all being released in different quantities in different areas, from utero onwards (testosterone exposure in utero affects brain development) and affecting how well neurotransmitters or synapses work....

Well it's an extremely complicated picture, but it does not surprise me that certain combinations of all the above- certain volumes of cortices, certain models and firing patterns of neural networks, certain releases and activities of hormones, may be, overall and in general, more typical for female rather than male brains, and vice versa, and lead that individual through a matching, identification process with their apparently opposite gender. And there will be a lot in large, varied grey areas with mixed characteristics, and these people might identify as non-binary or be quite happy with being male or female as per their genitalia.

And even then, I'm not saying it's that straightforward, because I would think that in addition to what might simply be more typical for a male / female brain there is that element that leads them to determine it is important for them to claim that identity for themselves. So 2 individuals with the same sort of patterns of structure, activity, hormone presence that might lead an expert looking at their brains to to say 'yeah, I'm pretty confident that these 2 individuals are both male' and yet, when speaking to those 2 people one would identify as male, and 1 would identify as female. Now this might also be due to certain brain differences somehow connected with the importance of claiming identity- but not necessarily inherent to any female/male typical patterns. I'm not sure if that makes sense.

And of course there all the social influences at play as well, I certainly do not underestimate the impact of these, from countries which are more accepting of gender dysphoria but not of homosexuality, to dramatic changes in the number of 'female assigned at birth' young people who feel they are male.

If you scan some people with a certain disorder and you are looking for there to be differences in their brains it is more than likely you'll find some.

Just a quick google found me an article suggesting that anorexics have subtle structural brain differences and if you can't find a structural difference then get out the trusty functional MRI scanner and there are bound to be some differences in blood flow. I found an article claiming that for BDD too.

The clinical significance of these rather subtle differences is far from certain however. Are they the cause of the overvalued ideas? No-one can say. They might mean nothing at all.

I think it's the same for gender identity. I am sure you can find some subtle differences from 'typical' male brains if you go looking but whether these are the cause of the gender dysphoria can't be said with any certainty.

I think that things like the recent massive surge in rapid onset gender dysphoria in teenage girls and the association with religious/ homophobic cultures is heavily suggestive of a psychosocial rather than a biological cause myself.

IF (and it's a big if) there actually are any subtle differences in male and female brains due to hormone exposure or whatever then they are subtle and on a spectrum not a clear binary like genitals are.

(And yes genitals and reproductive organs are definitely binary except in rare cases of disordered development)

It might be something like on average women are more empathetic but there will be a huge overlap where there are still lots of empathetic men and lots of unempathetic women.
That makes it not hugely different to height really apart from that there would be a lot of different traits making up a personality.
If an empathetic man is told by his parents and society that he is 'girly' and 'not a proper man' for having that trait then he may conclude that she is actually female but it's not his body or his brain that is wrong it's the society he lives in that forces him to conform to rigid sex stereotypes.

I think it's the same for gender identity. I am sure you can find some subtle differences from 'typical' male brains if you go looking but whether these are the cause of the gender dysphoria can't be said with any certainty.

It's a bit of a coincidence though isn't it? That is just so happens that the expressed gender identities of some young people happens to match up with what brain scans might also sex them as, despite their genitalia saying differently?

Do you think if they were looking for evidence of schizophrenia in brain scans of people with gender dysphoria they would find evidence for that too? Do you think they would find this evidence just because they wanted to look for it? I don't think so - do you? Yes, studies are carried out because they are expressly interested in discerning something, it doesn't mean the results have no meaning.

But it is puzzling, isn't it? Why do these studies of trans people' brains tend to show structural and functional similarities to their preferred sex rather than their body sex? Why do you think this is happening?

Is there any evidence of this? In a previous post you linked to a press release about a conference presentation, and an article on the website of a clinic. Can you link to any peer reviewed research to back up your assertion?

The conference paper you linked to was discussed on an earlier thread here.

www.mumsnet.com/Talk/womens_rights/3840671-Transgender-brains-are-more-like-their-desired-gender

That is just so happens that the expressed gender identities of some young people happens to match up with what brain scans might also sex them as, despite their genitalia saying differently?

Have you found any evidence that anyone has been able to determine someone's sex from a brain scan?

A lie, repeated often , does not turn into the truth

If an empathetic man is told by his parents and society that he is 'girly' and 'not a proper man' for having that trait then he may conclude that she is actually female but it's not his body or his brain that is wrong it's the society he lives in that forces him to conform to rigid sex stereotypes.

I tend to agree, but I am not gender dysphoric so I can't lay claim to fully appreciating the sense of the experience.

The thing is, I'm concerned that the hostility and divisions that exist at the moment are not helping matters, if the overall hope is that there is less surgical intervention.

There are campaigns to remove the T from the LGB or 'Get the L out'. When these teenage girls with gender dysphoria strongly identify as male, they feel they are not welcome in inclusive spaces anymore, where they might get to see more variety of gender expression that might help them reconsider determination to transition. They instead might just see the friction and double down on their ID as male.

When people persevere in refusing to accept new names and pronouns for them and insist on calling them 'she' and 'her' when they have asked for 'they' and a gender neutral name, my concern is they are thinking to themselves 'What do I have to do next to be accepted for who I am?' 'Nobody is respecting my request to be known as *. ' If I take the hormones and have the surgery, maybe I will be treated more seriously and they will see then that I am really male? This is something I need to do to be accepted for who I am.'

I would be happy to address anyone with whatever pronoun they choose. That is not harmful. (I do object to being forced to choose one myself as though this was some kind of normal thing to do when it is not)

I would say to any young woman of my aquaintance who thought she was a man that I cannot accept that belief as reality but I accept that her feelings are real and I would try to encourage her to think about why she might have those feelings, to accept the reality that she is a woman but to see that having 'masculine' traits as a woman is OK.

I do feel the brain scan thing is a bit of a red herring. We don't know if there really is a significant difference or not. What is very clear is that statistically people with penises are more dangerous for people without penises to be around no matter how they identify. People with penises are stronger and faster in sports no matter how they identify. Women often feel uneasy being naked in the midst of people with penises no matter how they identify. Honestly I can't see what difference brain scanning everyone would even make on a practical basis. You are free to identify how you wish but we can't base our laws on an internal feeling.

'Do you think they would find this evidence just because they wanted to look for it?'

In a word yes.

That is what research bias is Finding the outcome that you expect/ hope to find. Scientific research is littered with it whether it eg drug company sponsored trials that magically always show the drug has a benefit and few side effects.

The only way you can be sure an effect is not due to bias is to have a control group and to do a double blind randomised trial. I am not sure that most research in this area is up to that standard. Nothing anyone has linked to so far has hugely convinced me.

In general comparative brain scan studies are not as straightforward as they seem because human brains have huge inter individual variation and when you try to combine scans to get a group effect you need to employ considerable statistical jiggerpokery that further adds to the potential for biased reporting.

I would be happy to address anyone with whatever pronoun they choose. That is not harmful.

I disagree.

Pronouns are Rohypnol

Having now checked it is as I feared the study linked to has no control group and no blinding and is not even a structural study but a functional one which requires huge levels of statistical manipulation to get meaningful data.

But it is puzzling, isn't it? Why do these studies of trans people' brains tend to show structural and functional similarities to their preferred sex rather than their body sex? Why do you think this is happening?

It isn’t happening. It’s made up bullshit. There is no “evidence” for this at all, just biased reports.

The thing is, I'm concerned that the hostility and divisions that exist at the moment are not helping matters, if the overall hope is that there is less surgical intervention.

It's worth thinking about why those divisions exist. The main group pushing back against gender ideology are feminists. It should be obvious why this is - because gender ideology is all about reinforcing gender stereotypes, which is something which feminists fight against.

There are campaigns to remove the T from the LGB or 'Get the L out'. When these teenage girls with gender dysphoria strongly identify as male, they feel they are not welcome in inclusive spaces anymore, where they might get to see more variety of gender expression that might help them reconsider determination to transition. They instead might just see the friction and double down on their ID as male.

But why have teenage girls suddenly started identifying as male? This was unknown until very recently. Where did this idea of 'gender expression' come from? Why does anyone need or even want to 'express their gender'? What is the purpose of it? Why can't girls just be themselves? Why do they need a 'gender' label?

Abridged If people don't use preferred names, pronouns etc it forces girls to think what else must I do to be accepted as myself

What happened to me growing up was that I was made to realise that I didn't have to do anything, the fault was with narrow minded sexist other people .

It is not my job to force other people to think in a certain way, it was just my job to be me. I was fine, they were not , ignore them, they are jealous etc etc.

One really memorable day was when I was helping dad service our car and his big hand couldn't reach in to the oil filter , my smaller female one did...showing that what I saw as physical disadvantage could actually be an advantage .

One really memorable day was when I was helping dad service our car and his big hand couldn't reach in to the oil filter , my smaller female one did...showing that what I saw as physical disadvantage could actually be an advantage
That’s a lovely example - and nails the whole issue - I feel strongly that we should be learning how to be happy in ourselves with whatever body we’ve got. Those of us lucky enough to have our health have everything - when you don’t have your health you realise how important it is and it makes me sad to see these kids being encouraged to embark on a journey of untested drugs and major operations rather than learning to love what they have. As many transitioners seem to be finding out that once the major part of the medical journey has been completed they haven’t necessarily eased their mental distress.

When I was at secondary school, a Christian rock band played a gig in the school hall and before the end of the day many of the (atheist) girls in my year were fully signed up Christians with daily prayer meetings and going to a local Happy Clappy bible college.... for a few months then it tailed off. Luckily no one made any permanent changes in their lives but they were all deadly serious at the time (I remember being amazed at the strength of feelings they had about it). We had a fairly mixed teaching staff with several butch lesbian teachers (nobody made a thing about it though (and everyone just got on with teenage stuff and trying not to get pregnant) and it occurs to me that they might have been helpful role models for the girls to demonstrate that we didn’t have to confirm to narrow gender stereotypes.
As op I am so grateful to all the contributors to this thread for the thoughtful and insightful points and it has helped to expand my understanding of this topic. It certainly chimes with the situation of a teenager I have known for a long time who is currently fundraising for a double mastectomy and hormone treatment because she identifies as ‘gender queer‘ and wants to make herself more masculine - I am so sad for her situation.