Five criteria |
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Determining a cause for transsexualism not only needs to be practical and able to provide answers for people with transsexualism, it must also be scientifically credible. Such a theory would need to satisfy five criteria. It needs to:
The 'mental illness' theory, as the cause for transsexualism, has been one of the most damaging answers psychological or psychiatric theory has ever provided. These theories explains transsexualism as a failure to socialise into the 'correct' gender during childhood and adolescence, which then results with an adult engaging in 'sexually deviant practices'. These adult practices apparently bring on a 'mental illness', leading to an urge to 'change sex'. This psychopathological viewpoint has not only lead to the condition still being listed in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) of Mental Disorders, under the term "Gender Identity Disorder" (GID), it has also persistently categorised transsexuals (particularly women) as sexually deviant and in need of psychiatric treatment. Treatment based on the 'mental illness' hypothesis tends to be 'conditioning' and/or aversion therapy type treatments, causing long-lasting damage to the newly emerging self-concept of the individual. These treatments ultimately reduce the chances of the person ever finding peace. Girls are frequently regarded (and can eventually come to regard themselves) as 'deviant males' rather than girls or women. Boys can come to regard themselves as 'deviant females' rather than boy or man. Psychological treatments aimed at 'curing' or 'erasing' the discomfort of the individual are known to be short-lasting, damaging and unsuccessful. Research shows a relatively low level of psychopathology both before and after treatment, undermining the classification of transsexualism as a 'severe mental disorder'. If transsexualism were a result of dysfunctional childhood socialisation, then a far higher incidence of transsexualism would be evident in the general population. Psychological theories also tend to have an inconsistent application to men and women. Much of it is directed specifically at women (identified male at birth). Many of these theories are so flawed they cannot be applied to men (identified female at birth). One example is Ray Blanchard's 'autogynephilic' theory, supposedly applicable only to women identified 'male' at birth. Anecdotal patient accounts regularly report male psychologists (and psychiatrists) never doubt why a man (identified female at birth) requires treatment, despite having the appearance of a normal looking woman, while women (identified male at birth) who seek treatment are often considered 'psychologically disordered'. The only possible strength of the psychological perspective is the encouragement for gender-variant individuals who might have experienced abuse and trauma related to their sense of self and gender in early childhood, to explore alternatives to irreversible treatments. Even then, this strategy is often coupled with surgical or hormonal solutions. Psychotherapy offers people with gender conflicts who have 'transsexual-like' symptoms, some solutions which are firstly non-invasive to promote a personal acceptance of gender and improve their emotional symptoms. Beneficial solutions also include medical treatment through options such as low-dose hormone therapy, support to live in another gender role and access to some surgery. It was as early as 1972, the American Medical Association Committee on Human Sexuality published their medical opinion that psychotherapy was generally ineffective for transsexual adults. It is conventionally understood, in cases of transsexualism, medical assistance should be available to 'fix the body, rather than fix the mind'. SummaryIt is increasingly understood transsexualism is not a mental disorder, a social perversion (crossing the cultural norms of a person's society or culture) or a 'lifestyle choice' (cross-dressing or performance art). It is no longer confused with sexual orientation, deviation, gender roles or other gender related disorders and cannot be overcome by contrary socialisation, psychological or psychiatric treatments. It is possible to offer symptomatic relief and realignment for the physical aspects of the body which cause the most discomfort. The tools of psychiatry or psychology have a role as supportive measures for men and women in this situation, rather than diagnostic tools or treatment options to 'erase' their feelings. In recent years researchers associate the transsexualism condition with a neuro-developmental process in the brain (aka brain-sex).
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