4 ms·

I think quite a few identity-centered mental illnesses might actually be particular delusions, and in some cases we may be grouping people subject to one mental

I think quite a few identity-centered mental illnesses might actually be particular delusions, and in some cases we may be grouping people subject to one mental abnormality with others who are under the delusion they have that abnormality. That could explain why certain subsets of people exhibit symptoms which don't match the normal presentation. For example, and anecdotally based on my personal experience, people under the delusion of being transgender get grouped together with people who are actually transgender. The "real" transgender people behave about the same way before and after their transition. They carry themselves like their gender, they talk like it, they react like it, and the biggest change after transitioning is them getting happier. The ones I hypothesize are actually subject to a delusion of being transgender don't act like that. Their personality shifts radically after transitioning and they behave like an exaggerated caricature of their target gender and have a very difficult time navigating small group dynamics of their target gender. I've seen similar patterns with people whose presentation of disorders like DID and Tourette's Syndrome differ radically from the clinical symptoms but match the pop culture presentation.

naravara 5y ago
> The ones I hypothesize are actually subject to a delusion of being transgender don't act like that. Their personality shifts radically after transitioning and they behave like an exaggerated caricature of their target gender and have a very difficult time navigating small group dynamics of their target gender. If they’re on the autism spectrum, though, they’d have trouble navigating small group dynamics regardless so what you’re describing could just be a comorbidity.
- zozbot234 5y ago
  What parent describes seems more akin to gender-related disphoria. There's actually some very real controversy among trans activists as to whether disphoria should be viewed as a necessary condition for trans status, as currently asserted by most in the medical community.
humbugtheman 5y ago
This is a vast oversimplification of the range of transgender experiences, and the connotation that people "fake" being trans is all too familiar, but misinformed.
lkey 5y ago
"The ones I hypothesize are actually subject to a delusion of being transgender don't act like that. Their personality shifts radically after transitioning and they behave like an exaggerated caricature of their target gender and have a very difficult time navigating small group dynamics of their target gender." Generally speaking, I doubt your trans friends (if you have any) would enjoy being hypothesized about in this way. The same is true for any marginalized group. Secondly, you seem to have decided what appropriate and inappropriate gender performance is all on your own, and then drawn a bright line between 'real' and 'fake' around it. You are probably not aware that, historically, for many trans women, if they didn't present as 'female enough' (as perceived by their doctor) they'd lose access to medical care. This is still true today in the UK and US to a lesser degree. So for example, if you were their doctor, your patients would talk about you behind your back and zero-in on exactly what lie they'd have to tell to get their treatments. Suddenly, you'd have ample evidence that 'fake' trans women don't show up in your office, reinforcing your beliefs. There is no one 'right' way to be a man or a woman, same is true for trans men or women.
- causality0 5y ago
  Those are all true statements but they don't seem to have much bearing on the question of whether we're improperly classifying two separate phenomena as the same thing. It could be an explanation as to why the vast majority of trans peoples' mental health is improved after transitioning but a small fraction begin to spiral.
  - easrng 5y ago
    Hormones change how feelings are presented and what stimuli produce what feelings. I'm on estrogen now, and things that used to cause me to shut myself away and enter a depressive spiral now cause me to just cry, which I suppose is healthier and much much less likely to result in self-harm. It seems likely that the spiraling you have heard of is just another possible result of people's brains expressing existing things differently after a pretty major change in their life.
  - lkey 5y ago
    > They don't seem to have much bearing on the question of whether we're improperly classifying two separate phenomena as the same thing. Ok, let's address this directly. First I should note that your account is entirely anecdotal, so I have no real tools to argue you out of this position, as you weren't argued into it in the first place. You saw these things and developed a theory that you believe explains your experiences. First, I think we should take a step back and first discuss what it means to be visibly trans. For the purpose of this discussion, I'd give this simple definition: Having gender dysphoria (or euphoria) and changing one's presentation in society to align with their preferred gender. This can also include medical interventions ranging from HRT to surgeries, and legal remedies like changing one's passport and birth certificate. I'm assuming you probably this definition unobjectionable. However, from here, you assert you'd like to make another division. 'trans fake/delusional' and 'trans real'. And I'd like to ask you what the purpose of such a distinction would be. Your stated diagnostic criteria for fakeness are as follows: A: "personality shifts radically" (not exclusive to trans people: gay people coming out, going to college, dating someone new, having kids, got sober, started smoking weed a lot) B: "exaggerated caricature of their target gender" (not exclusive to trans people: gigachad meme, cis female models, whatever goop is, male weightlifters, bro culture broadly) C: "difficult time with same-gender small group dynamics". (not exclusive to trans people: I've met lots of cis boys and girls struggling with this, fewer adults, but still common enough) D: "spiraling?" (not exclusive to trans people: tons of mental illnesses, difficult circumstances, trauma) Let's now interrogate the usefulness of this distinction in three contexts Medicine: Let's imagine for a second you are a doctor and you have two patients that are asking for testosterone. Both describe feelings of gender dysphoria, both have begun to transition socially. One is buff and crass with a manly hair cut, casual clothes, and an easygoing nature, you chat about football and whiskey. The other is demure, awkward, and shy. As if compensating, he is wearing what you consider to be a caricature of manly fashion, and he speaks with a silly sounding (to you) deep voice. It's clear he's uncomfortable being in the room with another man. Does your course of treatment change? If not, then the distinction is meaningless in the medical context. If so, see my previous comment. Legal: You are now a county clerk, you are faced with the same two patients above 2 years later. Both are seeking to change their legal name. The demure one now has a full beard and has filled out a bit, but you can still see the 'fakeness'. He talks about going out shooting, but it's clear he has yet to grasp the fine details of the 'male' culture he's trying to emulate. Do you deny him his name change? If not, then the distinction is meaningless in the legal context. If so, ... that's illegal, don't do that. Social: You are at a party now, same demure guy as before. He's trying to flirt awkwardly with another man, you can tell he's overcompensating and tripping over words. Do you treat him differently than your 'real trans' friends? If not, then the distinction is meaningless in a social context. Do you treat him differently than your other 'awkward' friends? If not, then perhaps this is the right label. So having explored some of the ways the distinction might be employed, what then is left? What is more 'proper' about this new distinction that warrants its creation? Having pondered this for some time, I believe that your first comment boils down to: Some trans men and women can be awkward, cringe, flamboyant, fragile, or performative in a way that makes you uncomfortable and/or suspicious. In response, you think their transness is inauthentic and you'd like to put them in a different trans specific social box (that you invented). Boxing stuff in and of itself is standard human behaviour, but it's important not to make this kind of thinking 'official'. If it were made official, it would make each of the categories above needlessly more difficult for trans people. Moreover, for older LGBTQ+ people reading this, the arguments about 'real' and 'fake' sound disturbingly similar to time-worn arguments used to invalidate them. "Bi people are just straight and faking it to be different." "Bi people are really just gay and don't want to admit it." "Ace people don't really feel that way, they just haven't met me yet snickers" "Demi people aren't ace at all, they are just faking." The list goes on, the arguments become tedious, and for me, it mostly boils down to this: Why should anyone care if random acquaintances met in passing are 'fake' or 'real' {insert minority status or mental illness here} I'd much rather accidentally accept a 'faker' than reject someone from misplaced suspicion. Honestly, I don't perform this kind of calculus at all in my day to day life. To my knowledge, I've never met a malingerer of any kind, and I don't think I'd be anything other than mildly irritated if I did. If you find the 'fake' trans people you meet to be annoying, use the label 'annoying' instead and don't hang out with them. It's far easier than inventing a new category of trans person, when the existing social labels like 'weird', 'over the top', or 'a total mess' are already sufficient.
acchow 5y ago
Are flamboyant homosexual men also caricatures and not “really” homosexuals? It sounds like you haven’t spent enough time with enough LGBT people
mjevans 5y ago
It would be extremely helpful for both groups if there were a test based on philological data that machines could measure. I am fearful of our medical technology and knowledge immaturity, that future generations might look back on as being as bad as leaches. Both groups need help, but it might be very difficult to get each the correct help so they can live lives they are happy with.
swatcoder 5y ago
Alternately, some people face more than one tough challenge in their experience such that their “clinical” presentation is modulated in chaotic ways by all the other shit they deal with. With all the championing of identifying as this or that, it’s easy to forget that identity is reductive and that whole, complicated, multifaceted people are involved. It’s certainly true that there are people who chase delusions, identify with some struggle for attention or to feel included in a community, but your approach of evaluating their “clinical symptoms” (are you a clinician?) probably isn’t a very accurate way of spotting them. In fact, it’s just really hard to do altogether, let alone from an armchair.
jollybean 5y ago
It's perfectly fair to talk bout this issues but I'll challenge a couple of those points: - I overwhelmingly doubt the notion of some material group of 'fake transgender' people, fully going through transistion, and then 'overacting' their gender as some kind of evidence that they are under 'transgender delusion'. It's frankly an outrageous statement - even though I'm sure you're just ruminating and don't mean ill - it's almost offensively uninformed. If you spend 1 hour with a few trans people, that view would be dispelled pretty quickly. - 'Transgender Delusion' is akin to saying 'gay delusion' and while there should be some space for 'straight talk' to the extent these things may exist, you can imagine what kind of reaction you'd get for calling people who self-identify as gay as 'just deluded'. - Also problematic in your statement is the notion that 'trans' is a binary thing, often it's not. It's not M->F and F->M with people 'flipping' into other socially normative appearances and behaviours. It's everything in between. - All of that said, I think it is fair to posit that because gender is softer issue int that most of us have probably more in common than separates by gender, and that it's clearly a bit of a spectrum ... some people have do have 'problems' with their gender identity, and though may not be 'deluded' ... definitely have issues with nailing it down. Combined with the assertive push for protecting identity expression, I think people revel in their confusion. Labels like 'genderqueer' make me think this is a possibility. - There is a political aspect to this as much as people don't want their to be, and it's really easy for people to assume a 'moniker' as part of their public identity that really isn't part of their core identity. For example, there were agender people in the past of various kinds, more of a creative or artistic statement to 'reject' the notion of gender, less so a material identity. - Multiple personality 'disorder' is outside the spectrum of gender etc. and the author is a bit off to make it so overtly political, but he's not wrong to point out that we have serious issues in culture with anything that speaks to the level of 'identity'.

naravara 5y ago

> The ones I hypothesize are actually subject to a delusion of being transgender don't act like that. Their personality shifts radically after transitioning and they behave like an exaggerated caricature of their target gender and have a very difficult time navigating small group dynamics of their target gender. If they’re on the autism spectrum, though, they’d have trouble navigating small group dynamics regardless so what you’re describing could just be a comorbidity.

zozbot234 5y ago
What parent describes seems more akin to gender-related disphoria. There's actually some very real controversy among trans activists as to whether disphoria should be viewed as a necessary condition for trans status, as currently asserted by most in the medical community.

humbugtheman 5y ago

This is a vast oversimplification of the range of transgender experiences, and the connotation that people "fake" being trans is all too familiar, but misinformed.

lkey 5y ago

"The ones I hypothesize are actually subject to a delusion of being transgender don't act like that. Their personality shifts radically after transitioning and they behave like an exaggerated caricature of their target gender and have a very difficult time navigating small group dynamics of their target gender." Generally speaking, I doubt your trans friends (if you have any) would enjoy being hypothesized about in this way. The same is true for any marginalized group. Secondly, you seem to have decided what appropriate and inappropriate gender performance is all on your own, and then drawn a bright line between 'real' and 'fake' around it. You are probably not aware that, historically, for many trans women, if they didn't present as 'female enough' (as perceived by their doctor) they'd lose access to medical care. This is still true today in the UK and US to a lesser degree. So for example, if you were their doctor, your patients would talk about you behind your back and zero-in on exactly what lie they'd have to tell to get their treatments. Suddenly, you'd have ample evidence that 'fake' trans women don't show up in your office, reinforcing your beliefs. There is no one 'right' way to be a man or a woman, same is true for trans men or women.

causality0 5y ago
Those are all true statements but they don't seem to have much bearing on the question of whether we're improperly classifying two separate phenomena as the same thing. It could be an explanation as to why the vast majority of trans peoples' mental health is improved after transitioning but a small fraction begin to spiral.
- easrng 5y ago
  Hormones change how feelings are presented and what stimuli produce what feelings. I'm on estrogen now, and things that used to cause me to shut myself away and enter a depressive spiral now cause me to just cry, which I suppose is healthier and much much less likely to result in self-harm. It seems likely that the spiraling you have heard of is just another possible result of people's brains expressing existing things differently after a pretty major change in their life.
- lkey 5y ago
  > They don't seem to have much bearing on the question of whether we're improperly classifying two separate phenomena as the same thing. Ok, let's address this directly. First I should note that your account is entirely anecdotal, so I have no real tools to argue you out of this position, as you weren't argued into it in the first place. You saw these things and developed a theory that you believe explains your experiences. First, I think we should take a step back and first discuss what it means to be visibly trans. For the purpose of this discussion, I'd give this simple definition: Having gender dysphoria (or euphoria) and changing one's presentation in society to align with their preferred gender. This can also include medical interventions ranging from HRT to surgeries, and legal remedies like changing one's passport and birth certificate. I'm assuming you probably this definition unobjectionable. However, from here, you assert you'd like to make another division. 'trans fake/delusional' and 'trans real'. And I'd like to ask you what the purpose of such a distinction would be. Your stated diagnostic criteria for fakeness are as follows: A: "personality shifts radically" (not exclusive to trans people: gay people coming out, going to college, dating someone new, having kids, got sober, started smoking weed a lot) B: "exaggerated caricature of their target gender" (not exclusive to trans people: gigachad meme, cis female models, whatever goop is, male weightlifters, bro culture broadly) C: "difficult time with same-gender small group dynamics". (not exclusive to trans people: I've met lots of cis boys and girls struggling with this, fewer adults, but still common enough) D: "spiraling?" (not exclusive to trans people: tons of mental illnesses, difficult circumstances, trauma) Let's now interrogate the usefulness of this distinction in three contexts Medicine: Let's imagine for a second you are a doctor and you have two patients that are asking for testosterone. Both describe feelings of gender dysphoria, both have begun to transition socially. One is buff and crass with a manly hair cut, casual clothes, and an easygoing nature, you chat about football and whiskey. The other is demure, awkward, and shy. As if compensating, he is wearing what you consider to be a caricature of manly fashion, and he speaks with a silly sounding (to you) deep voice. It's clear he's uncomfortable being in the room with another man. Does your course of treatment change? If not, then the distinction is meaningless in the medical context. If so, see my previous comment. Legal: You are now a county clerk, you are faced with the same two patients above 2 years later. Both are seeking to change their legal name. The demure one now has a full beard and has filled out a bit, but you can still see the 'fakeness'. He talks about going out shooting, but it's clear he has yet to grasp the fine details of the 'male' culture he's trying to emulate. Do you deny him his name change? If not, then the distinction is meaningless in the legal context. If so, ... that's illegal, don't do that. Social: You are at a party now, same demure guy as before. He's trying to flirt awkwardly with another man, you can tell he's overcompensating and tripping over words. Do you treat him differently than your 'real trans' friends? If not, then the distinction is meaningless in a social context. Do you treat him differently than your other 'awkward' friends? If not, then perhaps this is the right label. So having explored some of the ways the distinction might be employed, what then is left? What is more 'proper' about this new distinction that warrants its creation? Having pondered this for some time, I believe that your first comment boils down to: Some trans men and women can be awkward, cringe, flamboyant, fragile, or performative in a way that makes you uncomfortable and/or suspicious. In response, you think their transness is inauthentic and you'd like to put them in a different trans specific social box (that you invented). Boxing stuff in and of itself is standard human behaviour, but it's important not to make this kind of thinking 'official'. If it were made official, it would make each of the categories above needlessly more difficult for trans people. Moreover, for older LGBTQ+ people reading this, the arguments about 'real' and 'fake' sound disturbingly similar to time-worn arguments used to invalidate them. "Bi people are just straight and faking it to be different." "Bi people are really just gay and don't want to admit it." "Ace people don't really feel that way, they just haven't met me yet snickers" "Demi people aren't ace at all, they are just faking." The list goes on, the arguments become tedious, and for me, it mostly boils down to this: Why should anyone care if random acquaintances met in passing are 'fake' or 'real' {insert minority status or mental illness here} I'd much rather accidentally accept a 'faker' than reject someone from misplaced suspicion. Honestly, I don't perform this kind of calculus at all in my day to day life. To my knowledge, I've never met a malingerer of any kind, and I don't think I'd be anything other than mildly irritated if I did. If you find the 'fake' trans people you meet to be annoying, use the label 'annoying' instead and don't hang out with them. It's far easier than inventing a new category of trans person, when the existing social labels like 'weird', 'over the top', or 'a total mess' are already sufficient.

acchow 5y ago

Are flamboyant homosexual men also caricatures and not “really” homosexuals? It sounds like you haven’t spent enough time with enough LGBT people

mjevans 5y ago

It would be extremely helpful for both groups if there were a test based on philological data that machines could measure. I am fearful of our medical technology and knowledge immaturity, that future generations might look back on as being as bad as leaches. Both groups need help, but it might be very difficult to get each the correct help so they can live lives they are happy with.

swatcoder 5y ago

Alternately, some people face more than one tough challenge in their experience such that their “clinical” presentation is modulated in chaotic ways by all the other shit they deal with. With all the championing of identifying as this or that, it’s easy to forget that identity is reductive and that whole, complicated, multifaceted people are involved. It’s certainly true that there are people who chase delusions, identify with some struggle for attention or to feel included in a community, but your approach of evaluating their “clinical symptoms” (are you a clinician?) probably isn’t a very accurate way of spotting them. In fact, it’s just really hard to do altogether, let alone from an armchair.

jollybean 5y ago

It's perfectly fair to talk bout this issues but I'll challenge a couple of those points: - I overwhelmingly doubt the notion of some material group of 'fake transgender' people, fully going through transistion, and then 'overacting' their gender as some kind of evidence that they are under 'transgender delusion'. It's frankly an outrageous statement - even though I'm sure you're just ruminating and don't mean ill - it's almost offensively uninformed. If you spend 1 hour with a few trans people, that view would be dispelled pretty quickly. - 'Transgender Delusion' is akin to saying 'gay delusion' and while there should be some space for 'straight talk' to the extent these things may exist, you can imagine what kind of reaction you'd get for calling people who self-identify as gay as 'just deluded'. - Also problematic in your statement is the notion that 'trans' is a binary thing, often it's not. It's not M->F and F->M with people 'flipping' into other socially normative appearances and behaviours. It's everything in between. - All of that said, I think it is fair to posit that because gender is softer issue int that most of us have probably more in common than separates by gender, and that it's clearly a bit of a spectrum ... some people have do have 'problems' with their gender identity, and though may not be 'deluded' ... definitely have issues with nailing it down. Combined with the assertive push for protecting identity expression, I think people revel in their confusion. Labels like 'genderqueer' make me think this is a possibility. - There is a political aspect to this as much as people don't want their to be, and it's really easy for people to assume a 'moniker' as part of their public identity that really isn't part of their core identity. For example, there were agender people in the past of various kinds, more of a creative or artistic statement to 'reject' the notion of gender, less so a material identity. - Multiple personality 'disorder' is outside the spectrum of gender etc. and the author is a bit off to make it so overtly political, but he's not wrong to point out that we have serious issues in culture with anything that speaks to the level of 'identity'.