7 ms·

The mental health aspect is solved by the experts in that area of the field, the treatment is known. People in the public with little knowledge about the area

The mental health aspect is solved by the experts in that area of the field, the treatment is known. People in the public with little knowledge about the area constantly insisting on it not being solved and that it needs discussion is a bit like arguing about if we should tell people with heart problems to hit the gym while the heart surgeon is recommending a transplant urgently. That is to say very unhelpful and possible harmful.

leadingthenet 6y ago
The “treatment” is FAR from a perfect solution, and you pretending this is a completely solved problem is exactly what leads to tensions when talking about this topic.
- NestedLoopGoBrr 6y ago
  You’re right. Hormone therapy, surgical interventions, etc. — they all fail to meet the absolute goal of transition. But they’re good enough until we have something better. What is not better, is arguing that a discussion still needs to be had on whether or not we should consider transgender individuals as if they are deluded and mentally ill.
  - dmpk2k 6y ago
    > What is not better, is arguing that a discussion still needs to be had on whether or not we should consider transgender individuals as if they are [...] mentally ill. Why?
    - NestedLoopGoBrr 6y ago
      Because simply put it is arguing that people who are proven to be physically wired in a particular way are merely living a delusion. It is easy to not be fully aware of the state of research on this topic if it doesn’t affect you, but as a trans woman, I am extremely familiar with what I’m talking about.
      - leadingthenet 6y ago
        > are merely living a delusion. How are they not living a delusion? Do people with other physical dysphorias not live in delusion? Such as when you feel like your arm doesn’t belong to your body and you want it cut off? The answer that is politically incorrect, but completely obvious to anyone, is that of course those situations are analogous, and if you can reasonably say that one of these groups is deluded, you can say the same about the other one, too. Except in one situation we employ physical therapy, and in the other mental therapy. I’ve yet to receive a single explanation as to why this is, other than “experts know better”. No, that’s not good enough.
        NestedLoopGoBrr 6y ago
        > I’ve yet to receive a single explanation as to why this is, other than “experts know better”. No, that’s not good enough. That likely is because asking these questions of a general forum of people who are highly unlikely to be qualified to speak on the subject are highly unlikely to have an informed answer. But you’re conflating, confusing, and distorting two completely separate ideas here. What you described is called Somatoparaphrenia, which is not a dysphoria at all, but classified explicitly as a delusion. And while we can certainly agree that physical intervention is not the right strategy, at the behest of the individual suffering from the disorder, they would also be physically impairing themselves were it to be carried out. Transitioning does not produce such impairments, and in fact leads to a significantly improved quality of life, reduction or complete remission of depression, and overwhelmingly thus produces a better overall mental health in most cases. And again, I’m speaking from _experience_ on that.
        leadingthenet 6y ago
        I was referring to Body integrity dysphoria (BID), which does seem to be related to Somatoparaphrenia. Let’s not get into semantics about which is a “dysphoria” and which is a “delusion”. My point stands: neither of those is treated by amputation, except in exceedingly rare circumstances. > Transitioning does not produce such impairments, and in fact leads to a significantly improved quality of life, reduction or complete remission of depression, and overwhelmingly thus produces a better overall mental health in most cases. > And again, I’m speaking from _experience_ on that. I’d argue that your personal experience is irrelevant, precisely because there’s no way to establish that it’s not delusional. Could you even tell the difference between a genuine improvement of the underlying condition, and simply feeding someone’s delusions to the point where we’ve changed both them (physically), and society (to make them feel less disparaged)? Amputation often makes individuals with BID feel better too, yet it is extremely controversial, even among experts. My belief that the only difference is politics has not yet been shaken. Edit: since it seems like I’m unable to reply further, let me just add this. No, I don’t believe the above poster is delusional, I’m asking whether there is a way to even establish such a thing, and if not, where the ethical difference vis a vis treatment for BID lies. Again, the poster completely sidestepped these questions.
  - chillfox 6y ago
    This 100%
  - throwawaysea 6y ago
    Don’t you think that a man claiming to be a woman or vice versa is a detachment from reality that is delusional? And if someone is threatening self harm because other people do not accept their personality or claimed gender, isn’t that a sign of being mentally ill? I don’t mean “mentally ill” as a pejorative, although I understand it can carry that connotation. But I feel the definition plainly and unemotionally applies to such circumstances. I think trans people deserve safety and equal rights. But I am challenging the oft repeated claim that a “transwoman is a woman” or “transman is a man”. I can see the existence of a third gender, as has been the case in some cultures that have historically identified and acknowledged the existence of trans persons. But the push to reclassify existing genders as “cis”, or erase the existing genders, or conveniently switch between gender and sex when suitable, or erase female spaces like sports, all seem like forced views that are only being heard because of aggressive suppression of any dissenting thought.
    - DarkWiiPlayer 6y ago
      > But I am challenging the oft repeated claim that a “transwoman is a woman” or “transman is a man” I never understood how people are having that discussion. What gender a trans person is comes down to how you define gender and there's a clear divide between people defining it as more of a social thing and others defining it as a mostly biological thing. Saying "trans women are women" is really just saying "I don't think chromosomes and genitals are the main thing that defines gender. So ultimately this comes down to a disagreement about a words definition, which is utterly pointless (unless you're specifically looking at it from a language perspective I guess, in which case it's probably quite an interesting debate). One way or another, this has nothing to do with whether gender dysphoria is a delusion or not.
- xupybd 6y ago
  Yep my father used to be a youth social worker. To say any mental health issue is solved is a gross error. They can help people but each sickness and person takes a lot to figure out and years of counseling.
  - deleted 6y ago
    [deleted]
  - DanBC 6y ago
    Being trans is not a mental health issue. Gender dysphoria is a mental health issue, but gender dysphoria is being taken out of ICD 11 and the new classification - gender incongruence - will not be under mental disorders but under sexual health.
    - xupybd 6y ago
      I don't really think any of the fighting over classification helps. People need someone to help talk it through and find coping strategies. The people we employ to talk through such things work in a field we call mental health.
      - DanBC 6y ago
        In the UK context it very much matters because people are seeking to deny access to healthcare by calling it mental illness.
- chillfox 6y ago
  It is solved as well as current technology allows. Yes, that is not perfect, but it is pretty good. Not providing the current treatment just because it might be better some day would be cruel. And no, that is not what creates tensions at all. What actually creates the tension is that the affected group just wants to have equal rights and then be left alone while the other side does not want to allow either.
  - leadingthenet 6y ago
    > affected group just wants to have equal rights The affected group already has equal rights. What it wants is additional rights. You're being very disingenuous on this point.
- fatbird 6y ago
  Why should I care about your input on the quality of the solution? Do you have a personal or professional stake in it?
Blikkentrekker 6y ago
I can't imagine the frustration of psychiatrists with the common man's narrative that “mentally ill” is an insult. When a psychiatrist calls a man mentally ill, he seeks not to insult him any more than when a heart surgeon tells a man he is in need of heart surgery, but when the common man says “You're mentally.”, that is seldom earnest advice or concern, but rather a cheap insult, and consequently there is a cultural push to declassify many mental illnesses as such, all which would accomplish is that, say, health insurance coverage would no longer cover hormonal replacement therapy and genital confirmation surgeries, two effective treatments against the illness of gender dysphoria. The psychiatric consensus is indeed that gender dysphoria, a dehabilitating condition which affect's a man's functioning in society is a mental illness, as well as having various treatments therefore, — but since “mental illness” has become an insult in common parlance, one must be quite careful as to how to phrase that nowadays. I have a low opinion of the man who feels that “mental illness” is an insult, it speaks of his own views of the mentally ill and how he probably treats them as lepers and pariahs.
- NestedLoopGoBrr 6y ago
  The issue with categorizing gender dysphoria as a mental illness is no different than categorizing homosexuality as a mental illness. The gender dysphoria is a problem derived from what is effectively a birth defect. If someone had a malformed limb and because this has clear impediments in their life in social and physical terms, they experience depression with their physical condition. We don’t say “oh, your body dysmorphia is a mental illness, you just need therapy”, as not only is that a shit take, but now prosthetics are more viable and advanced.
  - Blikkentrekker 6y ago
    > The issue with categorizing gender dysphoria as a mental illness is no different than categorizing homosexuality as a mental illness. There is a very big difference: a homosexual person is not depressed and inhibited in functioning per sē, and this is why gender identity incongruence absent any gender dysphoria is not classified as an illness. It is also why depression caused by homosexuality is classified as a mental illness, it simply has no special name in this respect. > The gender dysphoria is a problem derived from what is effectively a birth defect. If someone had a malformed limb and because this has clear impediments in their life in social and physical terms, they experience depression with their physical condition. We don’t say “oh, your body dysmorphia is a mental illness, you just need therapy”, as not only is that a shit take, but now prosthetics are more viable and advanced. What does that have to do with anything? The recommended medical treatment for gender dysphoria is not based on mental therapies, but physical surgeries and hormonal therapies, so I'm not quite sure what you are attempting to imply here. The simple empirical finding finding has been that genital confirmation surgeries and hormonal therapies have been far more effective at reducing the symptoms of gender dysphoria than any mental talk therapy has ever had, just as with many of depression that are caused by chemical abnormalities in the brain, drugs that remove that abnormality have been found far more effective than talk therapy. Talk therapy is not a very common remedy that psychiatrists resort to. — it works only for a very select few conditions.

leadingthenet 6y ago

The “treatment” is FAR from a perfect solution, and you pretending this is a completely solved problem is exactly what leads to tensions when talking about this topic.

NestedLoopGoBrr 6y ago
You’re right. Hormone therapy, surgical interventions, etc. — they all fail to meet the absolute goal of transition. But they’re good enough until we have something better. What is not better, is arguing that a discussion still needs to be had on whether or not we should consider transgender individuals as if they are deluded and mentally ill.
- dmpk2k 6y ago
  > What is not better, is arguing that a discussion still needs to be had on whether or not we should consider transgender individuals as if they are [...] mentally ill. Why?
  - NestedLoopGoBrr 6y ago
    Because simply put it is arguing that people who are proven to be physically wired in a particular way are merely living a delusion. It is easy to not be fully aware of the state of research on this topic if it doesn’t affect you, but as a trans woman, I am extremely familiar with what I’m talking about.
    - leadingthenet 6y ago
      > are merely living a delusion. How are they not living a delusion? Do people with other physical dysphorias not live in delusion? Such as when you feel like your arm doesn’t belong to your body and you want it cut off? The answer that is politically incorrect, but completely obvious to anyone, is that of course those situations are analogous, and if you can reasonably say that one of these groups is deluded, you can say the same about the other one, too. Except in one situation we employ physical therapy, and in the other mental therapy. I’ve yet to receive a single explanation as to why this is, other than “experts know better”. No, that’s not good enough.
      - NestedLoopGoBrr 6y ago
        > I’ve yet to receive a single explanation as to why this is, other than “experts know better”. No, that’s not good enough. That likely is because asking these questions of a general forum of people who are highly unlikely to be qualified to speak on the subject are highly unlikely to have an informed answer. But you’re conflating, confusing, and distorting two completely separate ideas here. What you described is called Somatoparaphrenia, which is not a dysphoria at all, but classified explicitly as a delusion. And while we can certainly agree that physical intervention is not the right strategy, at the behest of the individual suffering from the disorder, they would also be physically impairing themselves were it to be carried out. Transitioning does not produce such impairments, and in fact leads to a significantly improved quality of life, reduction or complete remission of depression, and overwhelmingly thus produces a better overall mental health in most cases. And again, I’m speaking from _experience_ on that.
        leadingthenet 6y ago
        I was referring to Body integrity dysphoria (BID), which does seem to be related to Somatoparaphrenia. Let’s not get into semantics about which is a “dysphoria” and which is a “delusion”. My point stands: neither of those is treated by amputation, except in exceedingly rare circumstances. > Transitioning does not produce such impairments, and in fact leads to a significantly improved quality of life, reduction or complete remission of depression, and overwhelmingly thus produces a better overall mental health in most cases. > And again, I’m speaking from _experience_ on that. I’d argue that your personal experience is irrelevant, precisely because there’s no way to establish that it’s not delusional. Could you even tell the difference between a genuine improvement of the underlying condition, and simply feeding someone’s delusions to the point where we’ve changed both them (physically), and society (to make them feel less disparaged)? Amputation often makes individuals with BID feel better too, yet it is extremely controversial, even among experts. My belief that the only difference is politics has not yet been shaken. Edit: since it seems like I’m unable to reply further, let me just add this. No, I don’t believe the above poster is delusional, I’m asking whether there is a way to even establish such a thing, and if not, where the ethical difference vis a vis treatment for BID lies. Again, the poster completely sidestepped these questions.
- chillfox 6y ago
  This 100%
- throwawaysea 6y ago
  Don’t you think that a man claiming to be a woman or vice versa is a detachment from reality that is delusional? And if someone is threatening self harm because other people do not accept their personality or claimed gender, isn’t that a sign of being mentally ill? I don’t mean “mentally ill” as a pejorative, although I understand it can carry that connotation. But I feel the definition plainly and unemotionally applies to such circumstances. I think trans people deserve safety and equal rights. But I am challenging the oft repeated claim that a “transwoman is a woman” or “transman is a man”. I can see the existence of a third gender, as has been the case in some cultures that have historically identified and acknowledged the existence of trans persons. But the push to reclassify existing genders as “cis”, or erase the existing genders, or conveniently switch between gender and sex when suitable, or erase female spaces like sports, all seem like forced views that are only being heard because of aggressive suppression of any dissenting thought.
  - DarkWiiPlayer 6y ago
    > But I am challenging the oft repeated claim that a “transwoman is a woman” or “transman is a man” I never understood how people are having that discussion. What gender a trans person is comes down to how you define gender and there's a clear divide between people defining it as more of a social thing and others defining it as a mostly biological thing. Saying "trans women are women" is really just saying "I don't think chromosomes and genitals are the main thing that defines gender. So ultimately this comes down to a disagreement about a words definition, which is utterly pointless (unless you're specifically looking at it from a language perspective I guess, in which case it's probably quite an interesting debate). One way or another, this has nothing to do with whether gender dysphoria is a delusion or not.
xupybd 6y ago
Yep my father used to be a youth social worker. To say any mental health issue is solved is a gross error. They can help people but each sickness and person takes a lot to figure out and years of counseling.
- deleted 6y ago
  [deleted]
- DanBC 6y ago
  Being trans is not a mental health issue. Gender dysphoria is a mental health issue, but gender dysphoria is being taken out of ICD 11 and the new classification - gender incongruence - will not be under mental disorders but under sexual health.
  - xupybd 6y ago
    I don't really think any of the fighting over classification helps. People need someone to help talk it through and find coping strategies. The people we employ to talk through such things work in a field we call mental health.
    - DanBC 6y ago
      In the UK context it very much matters because people are seeking to deny access to healthcare by calling it mental illness.
chillfox 6y ago
It is solved as well as current technology allows. Yes, that is not perfect, but it is pretty good. Not providing the current treatment just because it might be better some day would be cruel. And no, that is not what creates tensions at all. What actually creates the tension is that the affected group just wants to have equal rights and then be left alone while the other side does not want to allow either.
- leadingthenet 6y ago
  > affected group just wants to have equal rights The affected group already has equal rights. What it wants is additional rights. You're being very disingenuous on this point.
fatbird 6y ago
Why should I care about your input on the quality of the solution? Do you have a personal or professional stake in it?

Blikkentrekker 6y ago

I can't imagine the frustration of psychiatrists with the common man's narrative that “mentally ill” is an insult. When a psychiatrist calls a man mentally ill, he seeks not to insult him any more than when a heart surgeon tells a man he is in need of heart surgery, but when the common man says “You're mentally.”, that is seldom earnest advice or concern, but rather a cheap insult, and consequently there is a cultural push to declassify many mental illnesses as such, all which would accomplish is that, say, health insurance coverage would no longer cover hormonal replacement therapy and genital confirmation surgeries, two effective treatments against the illness of gender dysphoria. The psychiatric consensus is indeed that gender dysphoria, a dehabilitating condition which affect's a man's functioning in society is a mental illness, as well as having various treatments therefore, — but since “mental illness” has become an insult in common parlance, one must be quite careful as to how to phrase that nowadays. I have a low opinion of the man who feels that “mental illness” is an insult, it speaks of his own views of the mentally ill and how he probably treats them as lepers and pariahs.

NestedLoopGoBrr 6y ago
The issue with categorizing gender dysphoria as a mental illness is no different than categorizing homosexuality as a mental illness. The gender dysphoria is a problem derived from what is effectively a birth defect. If someone had a malformed limb and because this has clear impediments in their life in social and physical terms, they experience depression with their physical condition. We don’t say “oh, your body dysmorphia is a mental illness, you just need therapy”, as not only is that a shit take, but now prosthetics are more viable and advanced.
- Blikkentrekker 6y ago
  > The issue with categorizing gender dysphoria as a mental illness is no different than categorizing homosexuality as a mental illness. There is a very big difference: a homosexual person is not depressed and inhibited in functioning per sē, and this is why gender identity incongruence absent any gender dysphoria is not classified as an illness. It is also why depression caused by homosexuality is classified as a mental illness, it simply has no special name in this respect. > The gender dysphoria is a problem derived from what is effectively a birth defect. If someone had a malformed limb and because this has clear impediments in their life in social and physical terms, they experience depression with their physical condition. We don’t say “oh, your body dysmorphia is a mental illness, you just need therapy”, as not only is that a shit take, but now prosthetics are more viable and advanced. What does that have to do with anything? The recommended medical treatment for gender dysphoria is not based on mental therapies, but physical surgeries and hormonal therapies, so I'm not quite sure what you are attempting to imply here. The simple empirical finding finding has been that genital confirmation surgeries and hormonal therapies have been far more effective at reducing the symptoms of gender dysphoria than any mental talk therapy has ever had, just as with many of depression that are caused by chemical abnormalities in the brain, drugs that remove that abnormality have been found far more effective than talk therapy. Talk therapy is not a very common remedy that psychiatrists resort to. — it works only for a very select few conditions.