Brilliant article: Trans Is Something We Made Up

[pattihews]

I thought this was really refreshing. A new angle on trans.

bprice.substack.com/p/trans-is-something-we-made-up

I've just written and deleted a long but erratic bit about neurodiversity as a medicalised cultural concept. I wonder what kind of cancelling I might get for that.

As someone with an ADHD diagnosis, I think you are both right to we wary of the ‘cancelling’ but also completely right. They’re is some kind of ‘human universal’ in the differences we currently express as neurodiversity or any of the conditions we group under ghat heading. Or potentially several different human universals.

I’m quite ambivalent about my diagnosis and the cultural siting of it. It’s useful (to me) in some ways. But I’m not entirely convinced that medication is the answer. It might be an answer, but to the wrong question. There are some quite good arguments around the idea that ND emerges as a ‘problem’ or ‘condition’ because of how society is organised and the prevailing cultural norms.

On the other hand, I find the ADHD is fake and you’re just making it up narrative deeply problematic. As that article describes, it is real; there is some aspect of the human condition that occurs across societies and it does cause significant problems for people in the 21st century western world.

But it becomes difficult to separate out questions about the cultural framing from the generally dismissive attitude to the underlying issue and the people experiencing it. which is true of trans and many other contemporary phenomena too. So people get defensive and feel their experience or even their very existence is being ‘invalidation’ or denied.

But, in a society that wasn’t obsessed with ensuring gender conformity (and controlling non-conformity), ‘trans’ wouldn’t exist in the ways it has emerged in the 21st century. It simply didn’t exist in this way even quite recently.

Apparently the behaviours and characteristics we define as ADHD are pretty benign, even desirable, in hunter-gatherer communities. They still exist and can be distinguished from other traits that may be more common in people. These characteristics become a problem because of how we live and what we expect from people here and now. We view and describe them as pathologies and impairments, where under other circumstances they’d just be neutral differences. Or we start celebrating them and clinging on to the ‘identity’ as how we define ourselves.

The trans thing really worries me from this exact perspective because I was a gender non-conforming little girl. In the 80s people around me used the cultural category ‘tom boy’ and largely left me to it. I grew up to be a feminist 🤣. If I were 30 or so years younger, I really fear for how my gender nonconformity would have been shaped by the cultural narrative around trans. It’s not that people were right or somehow more enlightened in the 80s; but the ‘Just a Tom boy’ narrative did give much more space without intervention.

You think the menopause is ‘made up’? A cultural concept?

I don't think the menopause is made up. But equally I don't think every single woman has terrible symptoms and needs to treat it medically. It has become very fashionable

I’m laughing at someone (a man??) saying that the menopause is “made up”. If only we could just dip in and out of it as some do with various ideologies such as, for example, being “trans”. If only.

The menopause is a cultural construction that we use to describe a human universal. The point is that there are other ways to culturally interpret biological phenomena, and that can make an enormous difference to people’s experience. Similarly, cultural shifts can cause things that were previously unproblematic to become so.

So the biological process through which women’s fertility tails off and stops is real. But the current menopause narrative around it is a cultural artefact.

Would be very interested to know how your daughter responds to the essay. The points seem sensible to me and I struggle to think of possible counter arguments.

Jeez!! I have no words. I hope you don’t really work with kids on the spectrum.

Phenyj - I’m not talking about your daughter, I haven’t met her. Without doubt lots of young people need help and support. I do know what masking is. I’m talking about pathologising normal behaviours and feelings. I would say I ‘mask’, I’m very shy and prone to worrying, but at work I maintain a cheerful and confident manner, it’s hard work and I have to make a conscious effort to smile at people. I think this level of masking is just part of the normal human experience though, I don’t know how/where the boundary between ‘normal’ and diagnosable lies. I think people would have very different ideas about what is normal depending on their own personality- I think it’s normal, dh finds it hard to imagine. I think it’s normal for lots of teen girls to be ‘good’ at school and then let off steam / be stroppy / get upset about things / need help navigating their emotions (not saying this is your dc). Some parents have different expectations and seek help for what I would consider to be pretty standard teen issues (again not you).
I think it’s normal for kids to come with a range of personalities.

NotDonna - did you actually read what I wrote? I am making the point that people are increasingly pathologising personality types that just don’t happen to fit our very narrow idea of what ‘normal is’. I am not talking about people with SEN.

You didn't offend me @Meadowfly and have a child diagnosed with ASD.

Human universal…what?

People? I think you mean “women”.

Perhaps it’s important therefore to make a clear distinction between “menopause as biological reality for women” and “menopause as it’s acknowledged (or not) within a particular culture at a particular point in history”.

I’m not sure what you mean by “menopause as cultural artefact” - isn’t “artefact” used to refer to a physical, tangible object?

I wasn't offended, more concerned - I think all parents who have been through the shitshow that it is ECHP have encountered the attitude that we're unnecessarily pathologising 'normal' range experiences, repeatedly.

The situation for most parents is the local authority refuses to do an assessment, so unless you've got the time, education (and frankly, money) to fight that, how could you ever discover if your child was outside 'normal' range? Or get effective help for them?

I am a secondary teacher in a large comprehensive. I teach DC every day who aren't on the SEN register but have great struggles accessing the work and complying with school rules and expectations, and are therefore in constant trouble.

I don't want my own child to rack up hundreds of behaviour points in secondary for neurological differences in her brain (essentially).

@Meadowfly yes I did read your post. You’re very much saying that a kid with ADHD is just a normal lively kid. Not really. And you’re forgetting inattentive type. I do agree that it’s the social conformity that’s much of the problem though. You are not allowed to fidget (my DD isn’t allowed her fidget toy in class, so rips her tights instead, little do they understand that fidgeting enabled concentration), be late, be impulsive, be disorganised, wear non-itchy home clothing, have meltdowns, not pay attention etc etc. They have to conform. If they can’t then they’re punished. So in order to fit in and cope with the expectations and not be punished (which is essential if they’re to have any reasonable self esteem) they’re medicated. Sad but true.
Similarly with your shy girl requesting an autism assessment. Maybe she’s not autistic and the assessment will say as much. So many go privately as there’s 3-4 year waiting list sometimes longer even with suicide attempts. The state of CAMHS is a nightmare. You’ve also judged that the parents are wrong in wanting the assessment yet you’ve no idea what difficulties she’s experiencing and what her and her parents see at home when the mask comes off.
You mention that there should be a different diagnosis for girls who have autism and mask etc. The DSM5 covers most types by calling it ASD and ‘spectrum’. The spectrum element does not refer to severity but differences. Just as colours on a spectrum are different. Blue is not worse than red, it is entirely different, but it’s a colour. Difficulties arise with a new diagnosis that could be on the ‘spectrum’. For example, if a child meets all the social communication difficulties of ASD diagnosis but don’t meet the obsessive element they are not diagnosed with ASD but with Social Pragmatic Communication Disorder. Not very helpful when actually appear to others as probably in the spectrum but can’t access support because no one’s heard of it. Too many diagnoses of similar things makes accessing support difficult, so the ‘spectrum’ notion works well in that respect.

But getting back to the trans issue. Absolutely society could make it so much easier for kids to be gender fluid, wear what they like, play with whatever toys, explore and have freedom without gendered constraints. I’m all fir gender non-conformity. Tomboys were an acceptable thing when I grew up - but not vice-versa though. But why even call them tomboys? They’re just girls doing what they wish.

That sounds really tough @NotDonna, for you and her.

I don't think trawling through historical accounts to come up with a few examples that seem like anorexia really tells us it's an objective underlying condition.

We can see by looking at recent history that it isn't - it appears in some places, not really in others, and with different presentations, not always among the same demographic.

The same is true of most of these kinds of what might be called psychiatric illnesses. They certainly represent some kind of problem going on within the individual but the behavioral expressions seem to be defined culturally.

Even with things like schizophrenia, which seem to present fairly similarly everywhere, the extent to which it's defined as a problem is not always the same, and the outcomes differ.

Then there are also iatrogenic diseases, which again are real, but we cause them. Something like ADD may well be both something that in the past simply wasn't seen as debilitating to the same extent it is today, but also may be worse or more common because of the environments we put children in, or expect adults to operate in.

This is an interesting one because it mirrors a general change around how we view normal human biological processes.

It relates to what Mary Harrington talks about when she says we are now in a transhumanist era.

Previously, people just generally accepted normal human biological processes as natural, even if they were not always comfortable. They weren't problems to be fixed, but instead part of human life: going through adolescence and getting used to the bodily and social changes there, becoming a mother with pregnancy and breastfeeding (or a father, though that's less physically instantiated.) Loss of fertility and often sex drive, the decline of muscle mass, hair turning grey, baldness, wrinkles,and eventually death.

People would try and mitigate some of these things, including with medicine, but the framing of them was that they are part of the natural life cycle.

This has really changed now, we now tend to think, well, this is an uncomfortable change, what can medicine do to stop it, or disguise it, or prevent it. Many people use cosmetic procedures, including non-invasive ones like hair dye, to disguise the normal effects of age. Lets replace those hormones which are now in natural decline. Loss of sexual virility in old age is seen as something like a disease process rather than as normal and natural.

From this perspective it makes sense that adolescents now think the normal physical and psychological pains of puberty are some kind of disease that needs to be treated medically and avoided, rather than seeing it as a growth process.

Interestingly I saw an article a while ago about a similar change in the approach of public health bodies to disease and their own role over the last 30 years or so.

And of course, when people are told that certain things are not normal, they do feel differently about them. It doesn't mean they aren't hard when people see them as part of a natural process. But people do feel very differently when something is framed as a disease process, or "wrong" rather than as just something everyone goes through. We can see that with the number of kids now who are feeling that puberty is something to be fixed and very scary.

Interesting posts @DemiColon Lots of food for thought.
I’m not understanding your last sentence though about kids thinking puberty is abnormal. I’m not sure that’s true. I’m also not sure trans has anything to do with a desire not to go through puberty. Can you explain please?

I’m not sure aging is seen as wrong either or a disease despite youth being on a pedestal in Western culture, especially for women. The menopause is a tricky one as for some the change in hormones goes largely noticed but for others causes a range of problems that can be quite debilitating. I’ve a friend who suffered terribly with anxiety related to the menopause so much so she couldn’t leave the house and HRT has transformed her. If I didn’t know her I’d have struggled to have believed how severe it was.

So this isn’t just about not wanting to get old, it’s more nuanced. But we do indeed live in a society of hair dyes, viagra, Botox. I don’t agree that people think aging is not normal, that menopause isn’t normal, that going grey or bald isn’t normal. I think we all know it’s normal. Just as we all know gender non-conformity is normal. What pushes people into transitioning is them not being allowed to not-conform. I’m not sure if I’m making sense.

I think the author’s ‘we made it up’ would be better said as ‘we are allowing this’. Reading her article I couldn’t help think in the first few paragraphs around PTSD that it’s a good thing that it was recognised after World War 1 and again after Vietnam despite the symptoms differing. Surely that’s not a bad thing. We are allowing different representations of the same psychological ‘illness’, we are not making it up but allowing it to be recognised. Same with ADHD, menopause etc, we are allowing them to be recognised, we are not making them up. Surely this recognition is a good thing?

Ah that was meant to be change in hormones goes largely unnoticed.

NotDonna

Kids know intellectually that they are meant to go through puberty and become adult. But they seem now to be interpreting the physical and psychological distress that is often part of that as abnormal and something that needs to be relieved. Discomfort with things like menstruation, the feel of it, the complexities of managing it; the sense of being in the wrong body that comes from it physically transforming so quickly; high levels of anxiety related to the new hormonal processes; the rebuilding of cognitive structures; getting used to operating in society as a person who is sexual and other people see as sexual - these all cause distress, and in many ways getting through those things is itself part of becoming an adult. Suppressing them, or hiding from them, results in not integrating mind and body into a whole that functions within an adult social structure.

The most direct reason so many kids seem to think this way is because they are being told in school and social media that if they feel distressed, it is a sign there is something wrong. But indirectly, changes in parenting over the last 20 years often seem to focus on making sure kids are never distressed or stressed. And adults are largely thinking the same way all around them - if they are physically uncomfortable, or struggling with the fact that they are ageing, or with the natural reduction of sex drive, or the consequences of biological processes, it's seen as totally normative, and even sometimes morally courageous, to attempt to subvert these effects.

This attitude is also behind a lot of the struggles people now have with questions around managing end of life care.

Interesting @DemiColon I’ve not come across the ‘puberty is distressing’ phenomenon at all. I’ve just mentioned this to my 3 teen girls and they are… ‘what?’
Whilst I know they’re ‘normal’ with regards to puberty I thought they’d say ‘oh yeah, TikTok this, Insta that’ but it’s not something they’re coming across. So there’s some hope that what you are seeing may not be too mainstream.

Not sure this is directed at me but of course I don't think the menopause is made up. It is a biological fact. You know, like being either male XY or female XX.

Many thanks to @kayrayhunter for the bump. What an interesting article, which I would never otherwise have read. I'm going to read the following article too.

I'm surprised, I would say many young people have always found puberty distressing to some extent It's probably more common than not.

I guess it depends what we mean by ‘distressing’ @DemiColon

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