Is being trans a 'disease'/mental health issue?

[SolveMyPrombles]

I'm asking on this board for deliberate considered responses so please do share your thoughts.

A lady on a local group has described being trans as a mental illness that should be treated with compassion not pandered to because it's a disease.

Looking into it more deeply I believe she's wrong and there is no current diagnostic manual that agrees with her take.

What do you think?

Trans women aren’t transitioning to mock women.

But trans people are not a monolith though. There are a range of motivations for men to claim they are women and try and convey that outwardly to society. The wigs, bad make up, ill fitting dresses all look like a bad caricature and are informed by the man’s perception of women. That is insulting to women.

They could repurpose that phalloplasty hospital for something useful like gynae services or some sort of maternity teaching centre of excellence. God knows we need it.

People can wear what they like. If they look stupid, that's on them, not me.

The hormones, however, as far as I know, can be stopped without harmful effects
That’s going to depend on the person and what surgeries they’ve had. Someone who has had their sex organs removed must be on hormones to prevent health issues

Would you personally be perfectly happy to stop hormones?

That’s going to depend on the person and what surgeries they’ve had. Someone who has had their sex organs removed must be on hormones to prevent health issues

Ah yes, you're right, I forgot to explore that case. However, there's no need for them to be on opposite-sex hormones; being on their own sex hormones would be enough to keep them healthy.

Would you personally be perfectly happy to stop hormones?

I already have, 6 months ago. I didn't need them anymore, because I'd reached the milestones I wanted (low voice, beard), and they were more dangerous than beneficial to the rest of my health.

Ah yes, you're right, I forgot to explore that case. However, there's no need for them to be on opposite-sex hormones; being on their own sex hormones would be enough to keep them healthy.
I find it staggering that you think forced detransition is an acceptable thing to do to people. Why should this be done? What good will it do?

I already have, 6 months ago. I didn't need them anymore, because I'd reached the milestones I wanted (low voice, beard), and they were more dangerous than beneficial to the rest of my health.
I’m glad you reached a point where you were happy with the changes, but just because you’re happy without hormones it doesn’t mean others will.

I find it staggering that you think forced detransition is an acceptable thing to do to people. Why should this be done? What good will it do?

Why? Because there's no study showing that transition does more good than harm. In fact, the Finnish study showed that psychiatric morbidity was higher after transition than before.

What good will it do? It will greatly reduce the stress on their body.

I’m glad you reached a point where you were happy with the changes, but just because you’re happy without hormones it doesn’t mean others will.

You're missing the point: I should have been helped to be happy with the body I had, and so should other trans people. That's what "treating trans as a mental illness" would do.

Note that no, I don't have any regret. I'm not a detransitioner in any way. I'm happy with the results I got, and I have long mourned and got over the few negatives. But that doesn't mean that transitioning was necessarily the best option. If there had existed therapy to learn to deal with my mind-body disconnection, that's what I would have chosen. And I believe that this therapy should very much exist.

Why? Because there's no study showing that transition does more good than harm
That is flatly incorrect. There are plenty of studies showing that transition has a positive effect, but you also find some reason that the study is invalid. Too small sample size, etc. There are many trans people that will tell you their life is better because they transitioned. I’m one of them, and I’m guessing you are too.

What you’re doing here is pulling the ladder up behind you. You got yours, so now everyone else can suffer. You’re happy with your changes. What about the people who are happy with their changes, but those will disappear if forced on the hormones for their birth sex?

You're missing the point: I should have been helped to be happy with the body I had, and so should other trans people. That's what "treating trans as a mental illness" would do.
You do realise this had been tried, right? You can look up the stories of people treated by NHS psychiatric services before transition was routinely available. All that did was cause trauma and they were still trans after.

You call it ‘forced detransition’, the rest of us would call it ‘not causing further physical and mental damage to vulnerable patients’.

When it was discovered that lobotomy or thalidomide (well once the manufacturer/strong advocates stopped being in denial) caused more harm than good it was stopped.

As pp points out, ‘transition’ - medically attempting to alter one’s body to resemble the opposite sex generally results in worse mental health. That is not acceptable and people continuing to advocate for this to be offered as a ‘treatment’ to vulnerable people are cruel and misguided.

You do realise this had been tried, right? You can look up the stories of people treated by NHS psychiatric services before transition was routinely available. All that did was cause trauma and they were still trans after.

Tbf that's an extremely different group of people to today's trans cohort, a large number of whom are merely troubled teens who have been told that they are trans by the internet.

It's cargo cut thinking IMO. Sympathetic magic. Performing rituals to immanentise the presence /spirit/ essence of a physical thing which you believe exists independently of the thing itself.

I agree - I think many posters here may have had form of body dysmorphia and struggled with puberty [often resulting in eating disorders in prior generations].

I think to many extents a period of feeling alien from your changing adolescent body and of being unable to reconcile the hormonal/psychological turbulence that comes with that is a normal, disruptive period in many young people’s lives. Many will, as a part of the process of coming to terms with their adult, sexed body have chosen to also reject gender stereotypes as they explore how that body exists and is perceived within the current culture. It’s not necessarily mental ill-health, just a period of mental instability or turmoil.

I think the latter has become too ‘pathologised’ - just as feeling low or anxious in the face of very reasonable social pressures or life events has now come to be labelled and medicalised, rather than accepted as a normal response to normal life events and something that, with time and self-care, you can navigate to the other side of. We’ve robbed our young people of opportunities to recognise ‘normal’ periods of stress and develop resilience and self-understanding in the face of those things and in doing so made them less and less capable of coping.

This generation are amongst the most privileged - they live in a time without war, without famine, where the standard of living has [until recently and except for a small number in society] never been so good. Where if they feel cold, they can turn a nob on the thermostat or order a cheap new sweater on line. Normal everyday abrasions - the ice forming on the inside of bedroom windows, the lack of central heating that meant showering in the uninsulated freezing downstairs bathroom with an electric shower that dribbled/scolded was the norm, that wearing a coat over your PJs to bed was what we all did; that if you ran out of cash or food the lack of credit and online banking meant you literally made do with milk on the turn, stale bread and cornflakes and noone complained… because it was normal. I am not saying there aren’t new stresses and pressures, but those little every day abrasions all helped make you more resilient. We’ve gone out of our way to give them better than we had, but in doing so have so protected and insulated them, that they bruise and crumble at mere ideas.

Just my opinion, obviously, but I think we’ve all unwittingly - and out of a desire to protect, care for and nurture in a way not accessible to us growing up - created a fragile generation. There are billions of quotes on how strength derives from surviving adversity and I’ve always ‘aah-ed’ at them and then moved on, but within those platitudes there is an essential truth - hardship does forge stronger and more self-sufficient societies. No idea how to fix it though…

That is flatly incorrect. There are plenty of studies showing that transition has a positive effect, but you also find some reason that the study is invalid. Too small sample size, etc.

Well yes, too small sample size does make a study invalid. That's science, not my decision.

More to the point: why hasn't a large scientific study been commissioned yet? You know, like the one WPATH once did... which they then suppressed, because it wasn't showing what they wanted it to?

There are many trans people that will tell you their life is better because they transitioned.

But is it better than if we still had our whole, healthy bodies while experiencing no dysphoria anymore? That is what I'm comparing transitioning to.

What you’re doing here is pulling the ladder up behind you. You got yours, so now everyone else can suffer.

On the contrary: I want better standards of care for current trans people than I received.

What about the people who are happy with their changes, but those will disappear if forced on the hormones for their birth sex?

It won't matter because they will be happy with their birth sex. You seem to be under the impression that I want to stop the current model of transition without proposing anything in exchange. That's not the case. This sub-thread is about treating gender dysphoria as the mental illness that it is, and thus developing a working therapy for it which doesn't touch the body (beyond possible psychiatric medicine).

You do realise this had been tried, right? You can look up the stories of people treated by NHS psychiatric services before transition was routinely available. All that did was cause trauma and they were still trans after.

Neuro-psychiatry has massively evolved since those times decades ago. It is high time another shot was taken at this problem, and the truly barbaric "cutting up body parts" model be abandoned.

You do realise this had been tried, right? You can look up the stories of people treated by NHS psychiatric services before transition was routinely available. All that did was cause trauma and they were still trans after.

You appear to be making claims based on the situation of a tiny number of now middle aged men but expanding that to include all people with a trans identity even though there are vast differences between them. Talk about treating all trans people as a monolith! Psychiatric knowledge has moved on significantly since the 1980s btw.

No thoughts on how the requirements of a middle aged father of four have any overlap either a traumatised autistic teenage girl?

You can be mentally ill and still function well enough to be a parent, hold down a job and live a ‘normal’ life.

But is it better than if we still had our whole, healthy bodies while experiencing no dysphoria anymore? That is what I'm comparing transitioning to.
I wouldn’t say my body is unhealthy and unwhole just because I transitioned and had SRS. My body is different but it’s not worse. I experience very little dysphoria to the point it isn’t a concern anymore.

It won't matter because they will be happy with their birth sex. You seem to be under the impression that I want to stop the current model of transition without proposing anything in exchange.
Therapy is not an instant or guaranteed fix, so whatever way you look at it you will cause a lot of distress in the intermediate period just to end up with the person being happy again. If they are happy and living a good life, why not leave them be?

If you have had surgery then your body is very much ‘unwhole’ and if you are on cross sex hormones then the massive hormone imbalance for your sex will eventually take its toll on your health. Bodies are not like Lego, you can’t make such changes without an impact on health.

I wouldn’t say my body is unhealthy and unwhole just because I transitioned and had SRS.

Mine is, and it would be a downright disaster if I'd attempted SRS (I don't scar well).

Therapy is not an instant or guaranteed fix, so whatever way you look at it you will cause a lot of distress in the intermediate period just to end up with the person being happy again. If they are happy and living a good life, why not leave them be?

I'm not proposing to force the currently transitioned people onto the mental illness therapy model. I'm not sure that'd be legal, let alone moral. Also, medically, keeping some current patients on an older model that works well for them, when a new and better one emerges, is a common practice from what I understand. And keeping on treating the consequences of a previous medical treatment is an integral part of medicine as far as I'm concerned.

What I'm proposing is that new patients be oriented towards the MI therapy model, as well as the currently transitioned people who desire it. So you wouldn't have to take it, while I'd be free to try it.

I'm not proposing to force the currently transitioned people onto the mental illness therapy model. I'm not sure that'd be legal, let alone moral.
I’m glad you said that. I’m not sure if it’s a 180 or a misunderstanding on my part, but your earlier comments suggested you were advocating for forced detrasitipn. You said there would be no adverse effects from stopping someone’s hormone therapy and have much it would save the NHS.

I checked my previous comments, and you're right, I misspoke. It was so obvious to me that people wouldn't be forced to jump from one therapy to another, that there would necessarily be a transition period where both treatments cohabitated for those who were already on the transition path, that I didn't make it clear. I apologise for that.

Explain why my body is unwhole? I certainly don’t feel that way. If fact, that was how I felt before surgery.

Being trans isn't a mental illness, and trans people are profoundly happy after coming out.

Yes, people with MH issues function - but to do it consistently, they need help. There is no pill or talking therapy which helps dysphoria, only transition.

Trans people suffer MH issues when they deny who they are.

Though the weird obsession transphobes have with every aspect of their lives and bodies obviously contributes.

Ii thought they weren't all the same, so how can you say they're all happy? That lot on reddit don't seem to be.

Such bold and sweeping statements that are so clearly wrong.

‘Trans’ people are not a monolith as someone recently pointed out. ‘Trans’ has been observed to be one possible treatment for gender dysphorua that has a poor record in improving mental health. People with distress around their sex are being let down by being funnelled along one path and their real psychological needs, conditions and traumas are being ignored and are left untreated. Actual trans people are saying that it isn’t the right treatment for all.

Why would you want anyone to be given treatment that doesn’t improve their situation and actually makes it worse?

If they were happy, they wouldn’t get so upset when people don’t “affirm their identities”. Happy people don’t demand others give up their words and spaces. I thought trans people were oppressed and vulnerable and there was a “trans genocide” going on because people refused to affirm them? Happy people don’t need lifelong medical intervention because they can’t accept themselves.