Sunday, 29 June 2008

Countering the apologists…

One of the things you learn when you transition is that some people who are seemingly supportive are in reality nothing of the sort. I call them the smiling apologists and I think there may be at least one on the TUC LBGT committee.

There are several arguments that they believe are sincerely in your best interest to justify the continuation of the mental illness pathologization of transgender and transsexual people.

Their real interest is self-interest (often financial sometimes political).

Here are the more common ones, what they mean and how to counter the argument.

“You might regret it” (It meaning genital surgery.)

First point a transsexual never does by definition.

A transgender might if they are convinced by a psychiatrist to transition and “go all the way”!

This of course illustrates the person who makes the statement believes you are not capable of making the decision because you are mentally ill.


The Mental Capacity Act of 2005 is ignored by NHS psychiatrists as regards transgender & transsexual people.

The Act makes a presumption of capacity - every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise.

Individuals must retain the right to make what might be seen as eccentric or unwise decisions.

“Some people have regretted the decision and sought to have the surgery reversed.”

Yes a tiny vocal minority have. These people’s stories appear time & time again as a justification for the need for multiple assessments over many years. The common factor is that someone else told them they were transsexual rather than transgender.

The reality of transsexualism is that it is a self-diagnosed condition. Only the individual can know the truth. There is a lot of evidence of transsexuals pooling knowledge to fit particular psychiatrists stereotypical views on what constitutes male or female. So you can con any psychiatrist if you want to.


The single biggest cause of “regret” or rather dissatisfaction is poor surgical outcome.

For transsexual and transgender people the main symptom is a unique type of depression, Gender Dysphoria.

My team wins I’m euphoric. They lose I’m pissed off, fed up but never dysphoric. Ah but the psychiatrists say Dysphoria is usually experienced during depressive episodes, but in people with bipolar disorder it may also be experienced during manic or hypomanic episodes. Dysphoria in the context of a mood disorder indicates a heightened risk of suicide.

Yes well that’s clear then!


Gender Dysphoria, if it did exist, is not caused by being transsexual or transgender. What is being pathologised is the reaction to abuse & rejection by society, friends, family and workmates.

It is the same as coming out if you are gay for transgender people making a temporary change. The difference for transsexual people is that they have no choice other than permanent change.

Transsexuals denied treatment could experience clinical depression and emotional problems, and an increased risk of suicide.

Transition takes years and must be medically supervised for a successful outcome.

It takes two years for legal recognition of a permanent change of gender presentation. Unless you are over 50 and go to Thailand it takes one-year post transition living to qualify for surgery. A psychiatrist’s report is needed but this can be obtained in a one-hour consultation.

Most GPs will not currently prescribe hormone therapy other than on a shared care with a gender specialist luckily not all gender specialists are psychiatrists.


Scare stories about the dangers of hormones are not based on valid scientific data. Cross sex hormone therapy has as many benefits as disadvantages.

Charing Cross Gender Identity Clinic is the gold standard/global leader in the care of transgender and transsexual people.

This is untrue. They don’t even accept the NHS "Guidance for GPs, other clinicians and health professionals on the care of gender variant people".

No other comments here for fear of a libel/slander case but ask a small cross section of transsexuals and you will many who discharged themselves and went private.


NHS Guidance for GPs, other clinicians and health professionals on the care of gender variant people can be downloaded from:

The transition process can be highly traumatic and may involve the person being off work for a long period of time.

Gender reassignment or rather gender affirmation surgery is not classed as major surgery but there are restrictions on lifting, bathing & sex for three months. After six months most people are fully recovered.


Incapacity benefit can be claimed for any period off work.

The Real-Life Test minimises risk of a mistake.

There is no such thing as a test you might be living in male, female or androgynous role but you either alive or dead. The “test” is to ensure maximisation of psychiatrist’s fees.


There is no valid statistical medical data to support this invention by psychiatrists.

It is important to demonstrate readiness for surgery.

Another meaningless psychiatric invention to justify delay and therefore more fees. NHS psychiatrists are known to use deliberate delay as a proof of determination to undergo surgery.


Delay in surgery has been shown to have no medical benefit rather the reverse.

Transsexualism is a trait, disease, behaviour, desire, mental illness, perversion, paraphilia (sexual perversion), political identity, lifestyle or sin.

Yes please pick one to reveal your particular brand of bigotry. The selection of any of these will reveal your support for heterosexual Caucasian male supremacy.

Most psychiatrists are heterosexual Caucasian males so by definition they can’t understand or chose not to understand anyone other than another heterosexual Caucasian male.


There are almost as many conflicting explanations of transsexualism as there are transsexuals. Surprisingly no one states the obvious that each individual is unique. Too dangerous that as it undermines social theory.

There are lots more ridiculous statements used to justify the mental illness pathologization but here are a selection of quotes that show the problems we face.

All these are from original letters in my possession so can be used without fear of libel or slander LOL

Quote Rosie Winterton Minister of State August 2006

The Department of Health is not responsible for deciding what is considered a mental disorder.

Surgeons are reluctant to commit to surgery in the absence of reassurance that the psychological impact of surgery will not be a negative one.

Quote Mrs S E Price Interim Chief Executive East Staffordshire Primary Care Trust September 2006

The recommendation of the Department of Health is that no gender dysphoria work is undertaken in the private sector because of the lack of certainty that standard protocols will be followed.

The NHS does not carryout cosmetic surgery. If this condition was not defined as a mental disorder, surgery would not be considered for funding by the NHS.

Evidence shows that there area large proportion of people who having had surgery regret the decision and some seek reversal.

Quote Rosie Winterton Minister of State October 2006

The majority of transgender people support the Benjamin Association’s Standards of Care.

The issues facing the Department for Constitutional Affairs and the Department for Health are rather different.

The Department for Constitutional Affairs had declared transsexualism is NOT a mental illness.

Quote Stuart Poyner Chief Executive South Staffordshire PCT December 2006

The inclusion of Dr Richard Curtis of the London Gender Clinic on a list of approved specialists issued by the Gender Recognition Panel does not make him an appropriate person for the PCT to refer your constituent to in respect of our clinical pathway.

Quote Rosie Winterton Minister of State January 2007

There is no specific exclusion in the Mental Health Bill for gender dysphoria and the position regarding gender identity disorders remains unchanged.

We acknowledge that gender dysphoria is clinically recognised as a mental disorder.

Quote Rosie Winterton Minister of State February 2007

We do acknowledge that those who have successfully made the transition from one gender to another may no longer have a mental health issue.

Quote Rosie Winterton Minister of State May 2007

It is not a matter for the Department of Health to define or differentiate between gender dysphoria & transsexualism.

The Department for Health does not see how transsexualism could reasonably be classed as sexual deviancy.

So there you have it.

The Department of Health is a law unto itself.

Psychiatrists will always support the mental illness classification.

The Human Rights issue of declaring someone mentally ill without any statistically valid scientific evidence is ignored.

We took HM Government to the European Court of Human Rights to get the Gender Recognition Act and now it is time to go back and rid ourselves of the curse of the mental illness classification.

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