I think this raises an important point. Whatever the problems with the current establishment, it is the current establishment. Our lives are shaped by it. I'm reminded of the ongoing issue of "gender dysphoria" being in the DSM. Clearly, transgenderism isn't a mental disorder and hence shouldn't be in the DSM. At the same time, this categorization is what makes it possible in the current system for a lot of trans people to receive medical attention, be covered by insurance, etc. Just removing gender dysphoria from the DSM without changing anything else would lead to material harm to a lot of trans people.
Gender Dysphoria is not listed as a mental disorder in the DSM-5. It's listed as a condition and it comes with important ICD-9 and ICD-10 codes that medical practitioners need to properly treat their patients. It comes down mostly to record keeping and billing. If a MtF patient is taking a medication typically prescribed to a male but they are listed as female with their insurance, the medication may not be covered or at a minimum it might need a Prior Authorization which means that the patient could go for a week or more without their medication. These names we give to various conditions (and I hate to call it a condition but I don't know what other words to use right now since we're in a medical discussion) are meant to help with the process of aiding the patient. One day we can get rid of insurance companies and focus on real healthcare. Until then, we need something.
Want to argue that it's BADWRONG to change what drugs you are giving a patient based on their race?
With respect, I don't see anyone in this thread making any claim remotely like this and I don't understand why you felt the need to bring this up. There was some discussion about whether some specific drugs were race-dependent, but no one was moralizing it.
Knowing and adjusting for the specific genetics and physiology of your patient, including the factors influenced by race and sex, including both your external birth gender and any hormonal and physiological changes since then in the process of gender transition, is a very good idea if you don't happen to want to accidentally harm your patient.
I don't see what you are reading in this thread that is saying otherwise.
I think something similar is happening with this idea of body sex versus brain sex. The idea of a prediscursive body is important in modern western medical science. It informs how transgenderism is considered. We can't excise just that one idea while leaving everything intact without causing harm to a lot of people. At the same time, the idea that all trans people fit a narrow spectrum of experiences, that all trans people desire the same process of medical treatments, hormone therapy, surgery, etc., is false. It excludes a lot of people. We're in a situation without an easy solution because the real world is s%+!ty like that.
What does it mean that some people pursue hormone treatment and surgery even though they are not strictly necessary for the experience of being trans or of transition?
I don't think it really means anything. Hormone treatment and surgery aren't necessary for the experience of being trans, but they are necessary for some people's experience of being trans. There isn't only one way to be trans.
...
The point is, the power within the medical establishment will influence how trans people act. Are people meeting the standards of being a trans person because those standards are accurate, or is it because they are acting that way so that they can receive necessary medical treatment?
Fair enough; this is likeliest issue to get my activist instinct going, actually, not entirely disinterestedly. I suppose I’m metaphysically inclined, so I’m interested in the differences in the ways of being trans, because they presumably mean something to the people who distinguish how they are (or exist, live, and so on, if you prefer) in such ways. Then we can get into whether the existentialists are right and all humans need to discover their own transcendence and all that. :)
Also, granted that no one ever escapes “The Discourse,” if I may be flippant, in this context I’m most interested in exploring what’s the best we can do to make sure that our understanding of the (medical) issues is accurate. (If discourse is a prison, how roomy can we make it and how easy is it to apply gilding?)
Thanks; I think I’ve got a better idea of your approach now.
Oh, I missed this earlier:
Women don't have prostates. A MtF transgender might have a prostate.
We can complete this syllogism: therefore "MTF transgenders" aren't women.
You might want to reword your post (if the time hasn't lapsed) to not say that trans women aren't actually women.
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Oh, I missed this earlier:Women don't have prostates. A MtF transgender might have a prostate.We can complete this syllogism: therefore "MTF transgenders" aren't women.
You might want to reword your post (if the time hasn't lapsed) to not say that trans women aren't actually women.
There's nothing for me to change. Don't try to extrapolate what I didn't say. I try very hard to say what I mean and to imply very little. Women (the sex not the gender) in general don't have prostates. They simply aren't born with them. Men transitioning to become women might have prostates. I don't know if it's removed during the procedure but even if it is, not all transgender go through the procedure anyway so it's perfectly fine to say that not all have prostates.
At no point did I state or even imply that trans women aren't women. I tried to make that clear when I mentioned that I am speaking only about biological term "sex" and not the social term "gender." Men and women who were born with a certain set of body parts (prostates, uteri, ovaries, whatever they are) have to accept that these make a difference sometimes. I'm not trying to take away from anyone's identity. This is a biological fact. Now, people can make adjustments with medical procedures and medication but there will still be some things that are not changed. Hopefully in the future this will be less and less of a factor.
The entire point of my original post and these continuing ones is that when people think that having to put their race or sex on a medical form (which was the original comment I replied to) they are not thinking about their health. They are confusing "sex" and "gender." As far as medicine is concerned, if you identify as male or female that's not nearly as important as giving you the proper medication based on your physiology.
There are a lot of meds that act differently depending on gender and race and age and diet (that last one often gets ignored but is an important part of the puzzle). It's better to do ones own research, I find, as the doctor is always missing something.
I think something similar is happening with this idea of body sex versus brain sex. The idea of a prediscursive body is important in modern western medical science. It informs how transgenderism is considered. We can't excise just that one idea while leaving everything intact without causing harm to a lot of people.It is more than just an idea, and you can not excise anything in science that happens to be inconvenient or politically incorrect. It simply is what it is, and we need to proceed rationally and humanely from there to achieve a good standard of patient care.
I think you don't understand the content of the ideas you are criticizing. You've characterized opposition to certain trends within medical or scientific practice as politically motivated. I can see the rhetorical use in positioning yourself as a defender of truth and science against irrational political interests. The problem is, this is a mischaracterization. Take the critique of the idea of prediscursive body. You've presented it as political correctness gone overboard, an attempt to excise an inconvienent truth. But that's a misunderstanding. I know it's kinda unsatisfactory to just suggest someone read several hundred pages, but if you want to understand, you should read Gender Trouble.
For a high standard of general medical care, you really do need to know that this particular patient was born transgendered and may have different care needs than someone who was born cisgendered.
Of course. Everyone in this thread seems to agree on this obvious point. I don't know why you seem to think this point is in dispute.
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I guess I’m most interested in your thoughts on what the ideal solution might be to the cultural muddle of sex and gender, particularly for people who might strongly identify within binaries. That is, if we can decouple gender from sex entirely, what sorts of work can ideas about sex do? Would we want to try to argue whether sex is a matter of gross anatomy, chromosomes, or hormones? I’m thinking in particular of the implications for how we might understand the range of trans* people’s desires, especially those who transition. What does it mean that some people pursue hormone treatment and surgery even though they are not strictly necessary for the experience of being trans or of transition? Is that just the result of the cultural mix-up of sex and gender, or are people onto something when they postulate differences between average neural structures and epigenetic influences? Is there a responsible and meaningful way to acknowledge our embeddedness in discourse when trying to do neuroscience, say, like a more sophisticated version of, “We’re trying to be objective but what we’re looking for and what we can conceive of are limited by the preconceptions we haven’t been able to shake off?”
Perhaps the most concrete example would be how we might think about transgender people who, in MagusJanus’ words, “want to transition to the sex they feel most comfortable as” (emphasis added), or trans people who distinguish more or less sharply between transsexual and transgender.
I guess my first thought is what exactly does it mean to say "identify within binaries." Admittedly, the way psychiatric diagnoses operates is based off a polarization of genders. For example, the DSM-V marks that distress at one's assigned gender is a characteristic of gender dysphoria. In this case, a patient is ushered into medical surveillance for gender dysphoria as a consequence of the insisted binary, not because the binary exists within them.
Now, maybe there are trans and cis people that depend on opposition identity ("I'm not a man") within a binary to assert a claim over their gender identity ("therefor, I am a woman"). If this is the case, I do think it produces a rather significant problem for what I generally supposed as circumstantial solutions (the open-ending of the gender question). If some trans and cis people need the closed question of gender to end with male/female, then two things happen. First, the closed question necessarily forecloses possibility for those who don't identify within the binary, those who don't concretely identify within the binary, and all those unspeakable case that can't be enumerated because of the closed landscape of this binary gender. Second (as a consequence of the first), trans and cis people who need the closed question must necessarily stabilize the binary and it's respective categories. The need for a closed question requires the removal of bodies that upset the social stability of sex/gender binaries.
Now, I am going to go out on a limb here and say that I don't think that either trans or cis people need opposition identity to assert a claim over their gender identity. I think cultivating a gender ought to be a positive process, where we appropriate the elements of our gender and accumulate our identity. I think that our current system places a great deal of emphasis of elements of gender that have been inaugurated into biomedical discourse, and as a consequence creates impossible situations for trans and cis people. The DSM-V outlines that to be diagnosed with gender dysphoria one must experience significant distress or impairment with their assigned sex. It isn't enough that people want or need to be the gender that they are, medical discourse makes gender a negative process, one where suffering is the "critical element of gender dysphoria."
Also, Annabel, could you go into what you meant about being “willing to entertain the materiality of gender articulated through sex” in a bit more detail? I’m feeling a bit dense that I’m not feeling sure that I know what that entails.
Sometimes we need to assert certain rights to treatment or justice through recognizing how sexed bodies are differentially treated. Because sex is articulated through gender, the materiality of sex is caught up in the oppressive, sexist social forces. Sometimes we need to assert rights based on sex (or the configuration of our bodies), and under those circumstances I am interested in entertaining those political projects.
Ann Fausto-Sterling's Sexing the Body: Gender Politics and the Construction of Sexuality (2000) and Sex/Gender: Biology in a Social World (2012) are two really good texts to read. Fausto-Sterling is a brilliant biologist and her grasp feminist and queer theory translates into two very elegantly put together texts.
So some medications, like isotretinoin, can cause serious birth defects....
Sigh... the conflation of being a woman and being (potentially) pregnant all rolled into strict barriers placed on medical access for women. And all for clear skin! sigh what's a girl to do?
Otherwise, that was a very informative list of medical practices organized around gender/sex and race.
I want to reiterate something I mentioned before: sex is a scientific/biological term. Gender is a social construct. Medicine does not care about your gender. It can care about your sex. Too often we interchange the terms but they really are separate terms.
I want to make plain something I have been implying and explicitly stating: scientific/biological terms are open to contestation because they are created through social practice (they are, if you will, social constructs). Medicine clearly does care about our genders/sex, otherwise psychiatrists wouldn't be interceding every time a person wishs to transition. They are not "really" separate terms, they are clearly articulated together and are only separated on provisional grounds for specific purposes. In this particular case, they're being separated as a means to safeguard biomedical authority: gender is being ousted because it clouds the clinical gaze, destabilizing the categories that medicine insists it represents unproblematically. The obvious rejoinder to medicine, after it has delicately circumscribed the sex categories to only include some sparse snippets of the body (the "bathing suit areas"), is to point out that said circumscription is a social process. In turn, this process fails to account for a number of bodies that fall outside the circumscription, and in the case of intersexed infants, inflicts serious medical violence on their bodies.
Gender Dysphoria is not listed as a mental disorder in the DSM-5....
The DSM is the Diagnostic and Statistical Manual of Mental Disorders. You really don't get much more "mental disorder-y" than being included in the book of mental disorders.
You'll forgive me for being incredulous at the vague claim that some medications work differently based on the gender of the patient.o.O Are you being serious?
...medications directed at sexed organs in the body don't necessarily correspond with gendered bodies taking the drugs. From this perspective, the necessity of gender assignment to patients falls apart: gender doesn't match up with specific organ composition, and thus requires a more detailed investigation that necessarily desexes prostates, ovaries, uteri, etc. Medical professionals are shamelessly clinging to gender as a diagnoses while simultaneously destabilizing the category: the modern shift in focus to treating prostates and ovaries emerges as a consequence of the irreducibly of gender. (And all this without even mentioning the kind of disciplinary power generated through the shoring up biomedical classifications of day-to-day life).
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So some medications, like isotretinoin, can cause serious birth defects....Sigh... the conflation of being a woman and being (potentially) pregnant all rolled into strict barriers placed on medical access for women. And all for clear skin! sigh what's a girl to do?
This is actually a really good example of a case where saying what we mean, instead of just collapsing everything into sex, would be good. Rather than saying that women should jump through hoops for this specific acne medicine, we should say that it's not appropriate for people who are or may become pregnant. This doesn't cut off the possibility of someone classified as a man being pregnant. It also doesn't equate woman with potentially pregnant person. Focusing on what we mean, rather than collapsing everything to sex, would benefit cis women here. Cis women who don't want and don't intend to get pregnant wouldn't be forced to jump through these hoops due to some paternalistic concern about their reproductive capacity.
This isn't something that's just for the benefit of trans and intersex people. Not collapsing many disparate things into the single category of sex benefits everyone.
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Okay, so, when it comes to discussions of transgender stuff I've mostly just been reading along and learning as much as I can. Trying to be respectful since I don't really understand, being a cisgender woman. However, at this point I feel like I really need to speak up on behalf of all of us who are just reading along....
Please for the love of whatever it is you find holy, write with clarity and stop it with the academic speak! It's not that your readers aren't bright enough to understand what you're saying. It's that the effort often isn't worth it. Especially when the jargon starts going in circles. At this point I've noticed several people starting to repeat points just to try and establish a point of common agreement or at least confirm that they correctly understood what was being said. What this means is that whatever the point (something about gender binaries being unnecessary in regards to medical terminology I think....my eyes kept glazing over as I tried to read it and I had too much homework to work on to spend that much brainpower on understanding a messageboard conversation) it is being completely lost on your readers. It would be really, really helpful if you would please try and rephrase your ideas to express them with more clarity, more brevity, and in such a way that people from many disparate walks of life can easily understand them. And just to make sure it's explicitly understood, I am using the plural you here. There are several people who are all communicating this same way, so this is not aimed at any one individual.
We collapse disparate things into categories because it lets us process the universe. As long as we're open...
It is more efficient that way.
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So some medications, like isotretinoin, can cause serious birth defects....Sigh... the conflation of being a woman and being (potentially) pregnant all rolled into strict barriers placed on medical access for women. And all for clear skin! sigh what's a girl to do?This is actually a really good example of a case where saying what we mean, instead of just collapsing everything into sex, would be good. Rather than saying that women should jump through hoops for this specific acne medicine, we should say that it's not appropriate for people who are or may become pregnant. This doesn't cut off the possibility of someone classified as a man being pregnant. It also doesn't equate woman with potentially pregnant person. Focusing on what we mean, rather than collapsing everything to sex, would benefit cis women here. Cis women who don't want and don't intend to get pregnant wouldn't be forced to jump through these hoops due to some paternalistic concern about their reproductive capacity.
This isn't something that's just for the benefit of trans and intersex people. Not collapsing many disparate things into the single category of sex benefits everyone.
It sounds great and might even work on some theoretical level, but not with human beings. We're pattern making creatures and we are going to sort people into categories no matter what anyone tries to do....
...We collapse disparate things into categories because it lets us process the universe. As long as we're open to exceptions and to changing those categories with the evidence, that's not a bad things.
I guess I just don't think that argument is convincing: human beings "[a]re pattern making creatures," therefor the patterned categories (gender) we've settled on are necessary/real/here-to-stay. Relegating Vivinane (and my, if I may be so generous) proposition to an unrealizable "theoretical level" does not necessarily follow from pattern making ability or tendency.
The very fact we can (and do) change these categories (and in very profound and incommensurable ways) shows that not only are these categories unstable, but that our ability to "pattern-make" the world doesn't exhaust the abilities we have to make sense of the world.
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every time I try to read this thread I feel like keanu reeves while he is talking to col. sanders
Digital Products Assistant
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every time I try to read this thread I feel like keanu reeves while he is talking to col. sanders
I am very sorry for that. Ideally, subjects like this are mostly about empathy and learning, but its easy to get lost in jargon.
Is there anything I can help clarify about being gay or trans or a gamer :)
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every time I try to read this thread I feel like keanu reeves while he is talking to col. sandersI am very sorry for that. Ideally, subjects like this are mostly about empathy and learning, but its easy to get lost in jargon.
Is there anything I can help clarify about being gay or trans or a gamer :)
crystal frasier for me, it is more about the tone that waxes and wanes throughout this thread, rather than jargon
though jargon does play a bit of a part
I am not a big fan of five dollar words for the sake of showing off one's verbal GDP but here we go...
the tone is often adversarial, combative, arrogant and condescending
I am more amenable to learning as well as more apt to empathize toward someone who is not a complete jerk, regardless of the subject they are speaking toward and regardless of the merits of their talking points
there are a number of subjects and viewpoints that are near and dear to me
when I speak to someone about them, I try to keep in mind that in their eyes, I am now a representative of that field/subject/viewpoint/lifestyle/hobby/etc and that my own demeanor and attitude have just as much of an impact, if not more, than the perspective I am conveying
okay now I am going to go back to talking about streaking with green hats in that other thread
And I think you're trying to have an extremely specialized discourse that no one else is volunteering to participate in.
Okay... Then don't participate in the conversation if you think it's overly specialized and useless.
If I am in the hospital about to get treatment, my ER doc will not, and really had better not, stop what s/he is doing to get a Gender Studies degree before treating me. I expect to be treated with dignity and with the effective practice of medicine. Both of those things are important, and neither of them require a sociology and gender studies background.
I don't think it requires a specialized background to understand that multiple disparate things are grouped into "sex". I don't think it requires a specialized background to note that this categorization is rife with variety and exceptions. Pointing you to a reference for a specific idea isn't the same as saying that anyone who has not read that reference is incapable of working in medicine. Please stop putting words in my mouth.
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oh hey good timing
Was I naughty?
Sorry...
Please stop putting words in my mouth.
That is the entire point of lynora's comment. Otherwise, people wouldn't "put words in your mouth" if they were clear about what you were saying.