I'm wary of psychoanalysts after their treatment of gays and lesbians. For decades they pathologized LGBT people, looked for causes, distant fathers, etc., wouldn't accept them for training. They had to be dragged into the modern age, and there are still homophobes present.
Striking how this resignation is being seized on by the usual anti-trans people, e.g., Gilligan in the Times, and of course, Mumsnet, always ready to put the boot in. I always wonder what they would prefer, just ignore people with gender problems, tell them it's a delusion, or try some gender reparative therapy?
Apart from some female gymnastics events, which sports or events do you think favour an anatomically female body? Overwhelmingly, the size, muscles, lung capacity and strength of the male body confer sporting advantage.
Equestrian events come to mind. Lower body weight is an advantage in many of them.
Also the Iditarod dog-sled race (Iditarod.com). 1000 miles. Women do well in it. Two have won: Libby Riddles won once, and Susan Butcher won four times. IIRC, there was talk of splitting the race into men's and women's sections, because women do so well--especially because of Susan's multiple wins.
The heavier people are more likely to require joint replacement later on of they've been doing these extreme events.
Psychoanalysis of the Freudian variety is rare today. Very old school. But aspects of its theories have been used in most other therapies. Starting with the idea of talking to people about their inner life, and how we may play out scenarios repeatedly in maladaptive interpersonal ways.
Here are the high school trans girl runners I mentioned earlier. They're in the news again for winning the state championship again. Looks like some of the families of the girls they beat are upset because there's athletic scholarship money at stake.
Yes, it could become a problem in amateur sport, which presumably will not require reductions in hormone levels for trans women. Well, the Olympics was prevented from doing that by the Court for Arbitration in Sport, that case still pending.
I don't know what the solution is at the level of schools and colleges. The right wing will just want to ban trans athletes. The idea of separate trans events seems horrible.
The converse argument is that many trans women receive a hormone blocker, (for testosterone), and synthetic estrogen, and the result is that they become slower at running. This may not satisfy critics however, who point to tall muscular trans women as unfairly competing in women's events.
I was wondering about the situation where it's currently usual to be able to employ someone of the same gender to perform an intimate caring role. The legal situation around transgender may affect this.
Yes, this has come up around some care jobs, and stuff like cervical smears, although are plenty of male gynaecologists. I think the Equality Act allows exemptions. And I think you are entitled to ask for certain carers, although saying no trans please might risk some comeback. But then can I insist on a male doctor? I haven't seen one in 20 years.
I think gender is treated differently, partly because it's accepted that some people feel uncomfortable having an intimate examination with an opposite sex GP. Of course, you can ask for a chaperone, but I think you can ask to see a man or woman. At my surgery, there are about 15 women and one guy.
It's not illegal, though, and I can see why a patient might prefer one gender to another for some kinds of therapeutic relationships. For instance, it doesn't strike me as at all unreasonable for a woman coming out of an abusive relationship with a man to want to get counselling from another woman.
About 15 years ago there was an unfortunate case in Canada where a trans woman tried to volunteer at a rape crisis centre and (as I understand the facts from the reported decisions) she was rejected out of hand the moment they realized she was trans. The centre went on to defend its actions in the courts on the basis that they had a right to exclude trans women from women-only spaces, a position that the courts ended up agreeing with for reasons that don't really make sense to me (15 years later, it's very possible that everything would have gone very differently from the outset).
I really do think both the centre and the courts got it wrong on the issue of principle here. That said, I can also see how even if they had given it a try, it might not have worked out for reasons that aren't really anyone's fault. It may be that as practical matter, to be an effective counsellor in the circumstances (at least back 15 years ago) the volunteer may have had to present more unambiguously as female than she was able to. But there's a need to navigate these issues in a way that respects all the relevant realities involved.
That sort of discriminatory behaviour if practised by the doctor would be illegal and I can't see why the reverse should be permitted.
In the US we are more used to seeing ourselves as customers or patrons of healthcare, and the idea that we must take one doctor and cannot choose another seems bizarre. It's like saying I MUST go to this convenience store and not that one, for some reason or other, whether I like it or not.
What mt said. And a lot of people really need certain demographics of health care providers in order to a) cope with them; b) trust them enough; and c) be willing and able to work on their health if that provider is involved.
I'm one of them. As much as possible, I need to have female health care providers--particularly my GP and any other that might see me less than clothed, or in a gown, or need to go poking around; but best to have females for everything else, too. It's due to many things, including #MeToo stuff. There was a time when I really couldn't cope with being treated by a male at all, even just for the beginning of the appointment interview, pulse check, etc. Some people understood that, when told. Others, including one particular woman doctor, didn't get it at all. (That woman had other issues, like supreme arrogance, not listening to explanation of symptoms I'd been living with for some time, etc.)
Anyway, after a lot of hard work and healing, I can be a bit more flexible. I'm sure there are women who prefer male doctors, even for gynecology. And there are men who prefer male or female docs, depending on all sorts of things.
I would think it normal for trans folks to want to feel safe with their health care providers. I know there are clinics here in SF for LGB folks who want an atmosphere that's especially geared for them. And I think there are some for trans folks, too.
I think you're basically right, but testing what you have said, would a devout female Clogologist doctor be able to refuse to treat a male patient if to do so would involve examination of his genitals - such conduct being prohibited by her religion?
I don't know the laws. But if she set up a specialty practice *from the beginning*, specializing in the needs of women and girls, she might manage it. I've sometimes thought that, if I were a doctor, I might do something like that.
And I think maybe some women doctors do just that in some Muslim countries.
But what about here,or the UK, Canada,the US etc with reasonably standard legislation.
Amd Mousethief - what is there to get or not get in posing a question for discussion?
In the UK, you are allowed to ask for a chaperone for treatment at the GP surgery. I'm not sure you can request a male or female GP, but we can choose which GP to see if booking far enough in advance, (not on the day), which means we have been able to choose the male or female doctor depending. The male GP prefers not to deal with gynaecological problems, even though he's been the better doctor for ever. And this surgery does have at least one each female and male GPs and one each male and female practice nurse.
I was thinking of say disabled woman employing personal support staff, who would possibly choose to employ female carers.
The NHS website says that you can ask for m or f doctor, but you may have to wait longer. You don't say. I thought the NHS was all about customer satisfaction now, hollow laughter.
There are several GPs who are trans, I wonder if they are inundated with patients.
Like I said, I don't know the legal stuff. I just think that having a clinic that treats a particular group isn't a bad thing. Now, if it were the only medical care for 10-20 miles around, they might want to consider having a day and an evening each week where other people could be treated. Win/win. (I'm pragmatic, and want to work things out as much as possible.)
We have various specialty clinics in town: LGBT (and different parts of that); women's; various ethnic groups, etc. Sometimes, LB clinics will take straight women, I think, and lend out their space to groups that aren't particularly LB oriented. (Went to a health-problem support group like that, years ago.) I think the ethnically-oriented clinics generally take other people, too; but I gather the patients are almost all of the ethnic group at some of those clinics. I've heard, accurately or not, of people outside the ethnicity not only feeling outnumbered, but (reportedly) being unwelcome and being sent/driven away.
OTOH, I went to a particular ethnically-oriented clinic off and on, for a while. I checked first, to make sure they'd be ok about my being a patient. (And I would've totally understood if they hadn't been.) I was always treated well there.
As to someone's mention of people preferring a white doctor: if someone is *really adamant* about that, *everyone* might be better off if that person saw a white doctor. Saves the possibility of trouble.
I also think it's ok if people of other ethnicities don't want to see white doctors and/or only doctors of their own ethnicities. E.g African-Americans run into a lot of bias (unconscious and otherwise) from white doctors, and ignorance about various differences. That can mean bad health outcomes.
IMHO, sorting out diversity, discrimination, personal preferences and comfort, rights, etc. can be difficult to do wisely.
Just reading an article by a doctor, who said that 1% of the population is trans. That seems a high figure, although some people use the the term to include anyone who is nonconforming. That is about half a million people.
Just reading an article by a doctor, who said that 1% of the population is trans. That seems a high figure, although some people use the the term to include anyone who is nonconforming. That is about half a million people.
I agree, that seems very high. Given that trans sites here do not give any estimates (or did not when I last checked a year or so ago) is suspect that the true figure is much lower that 1%.
And thank you all for your comments. Despite what nousethief suggested, I don't have any concluded opinions on the various issues. It's easy to understand that a woman may well prefer to see a female doctor about gynaecological matters, or a man see a male doctor about eg prostate questions. I can also see that there should be no legislative limit on choice by the patient but there should be by the carer. That still leaves some fringe issues. I can't see an obligation on a medical practice to employ both male and female doctors for example. It may be better if that happens but may well be impossible to always put into effect.
Patient choosing a doctor is a right. Doctor choosing a patient is not.
This is considerably easier to arrange under a system where the patient doesn't have a right to a doctor. A doctor who is in high demand doesn't have the ability to see more patients than their limit.
That patients should be comfortable with their doctor ought to be more of a priority than the reverse (though that's good too), and there are clear cases, such as a woman who would prefer not to have to even think about harrassment and would therefore like a female doctor, where the patients choice of a category of doctor should be met. But in general I don't think choice is a right.
Just to add: I realize the particulars are more difficult--possibly out of the patient's control--in national health systems.
Well, the NHS is supposed to be about patient choice, for example, choosing a hospital or a consultant. But then it would take me 2/3 weeks to see my own doctor, so I don't mind Hobson's choice, for a same day appointment.
Going back to the trans population, Wiki cites 0.6%, about half the number given above. Stonewall give 1%, but no-one shows how these figures are arrived at. I noticed that a study in Minnesota of adolescents ended up with a figure of 3%, which may indicate an increase among young people. It obviously has implications for health policy, and education, although as noted above, "trans" has a variable meaning, and can include non-binary, or in fact, anyone who is troubled by gender. Quite likely as well, is that suppression, both internal and external, is decreasing, and people are more willing to voice angst about gender.
This is a summary of the Minnesota study, and the original article is cited in that, published in the journal Pediatrics. They use the term 'trans gender gender non-conforming', and include genderqueer, gender fluid, or unsure about gender. Incidentally, 30% of TGNC youth reported a suicide attempt.
Yes, it could become a problem in amateur sport, which presumably will not require reductions in hormone levels for trans women. Well, the Olympics was prevented from doing that by the Court for Arbitration in Sport, that case still pending.
I don't know what the solution is at the level of schools and colleges. The right wing will just want to ban trans athletes. The idea of separate trans events seems horrible.
It's not "right wing" or "left wing". Sport doesn't really care about such politically laden issues. More so caring about things that give unfair competitive advantage. And second, things that will harm viewership when telecasts are broadcast or streamed.
Bollocks, conservative views of transgender are that it's a delusion, a fad, or a con-trick. Why do you think that the Trump administration is threatening to erase trans identities, and Obama was more favourable?
Patient choosing a doctor is a right. Doctor choosing a patient is not.
This is considerably easier to arrange under a system where the patient doesn't have a right to a doctor. A doctor who is in high demand doesn't have the ability to see more patients than their limit.
Sorry, I didn't think what I said was all that unclear. I'm not saying the patient has the right to DEMAND a particular doctor. But among doctors that are AVAILABLE, the patient may choose. Get it?
Doctors do terminate with patients. Usually for non-cooperation or adherence to a treatment plan, or for missing appointments repeatedly without reason. I am aware of surgeons refusing to perform surgery on patients who won't stop smoking.
Incidentally, some discoveries about the hormone androsterone indicate that the masculinization of mammalian fetuses is not simply because of testosterone, and that errors in the production and utilization of androsterone may lead to feminization in boys. No links yet, but will dig up.
Summary article on androsterone, and his final remarks are interesting, 'Those in society who are adamant that the only choice for people is a binary one of man or woman are not basing their views on biological reality'.
This article from Vancouver contains the position of a psychologist there. It arrives at about what I have been thinking and articulates it quite well. Teen sexual confusion or gender dysphoria? he compares it to ADHD, false memory and other trends.
...the recent excitement about gender dysphoria is leading to another wrong-headed trend, which will be doing more harm than good to students, for whom it’s normal to struggle with gender and sexual identity.... Often the diagnosis, and the prescription of puberty-blocking medications, is arrived at with very little real time being spent with the patient, for the diagnosis is made by a general practitioner (family doctor) who may or may not have had both the training and time to deal with this issue....This is a process that must not be undertaken lightly. It is a diagnosis that should be years in the making.
This article from Vancouver contains the position of a psychologist there.
No, it does not. Do you even read the links you post? It is from a retired teacher and school counsellor. Not someone with any expertise in the subject at hand. The author has no qualifications as a psychologist, and as near as I can tell, he may just as well be described as "some rando on the internet."
He seems to think that because he now feels shame and regret about some psychological theories he adopted - not all of which are disproved - that gender identity issues should be treated with skepticism... again, although he has no expertise to offer.
I don't understand why you think this person should be treated as authoritative when it seems to me he has no more authority about gender issues than the average person at the pub. Possibly less, depending on the pub.
Anyone who brings up Jordan Peterson to support their argument on anything gender-related reveals themselves to be utterly ignorant and gratuitously cruel.
Those are ad hominem arguments. I'm not fond of Peterson.
School counsellor or psychologist, he's been around for a good spell. Observed. Through other non-evidence based issues touted by experts. The main point derived is that adolescent sexual issues should not be gathered into transgender by default.
Do you think he has any point at all? That there is a community which may provide an interpretation which is then adopted?
I'm not sure what Wakeham is talking about, when he refers to the "panacea" of "you are a girl/boy trapped in a boy's/girl's body". Are there clinics which actually use those words? I think that kind of language is used in a popular way in the media, and by some clients. But at the Tavistock, quite a lot of clients do not transition, and are not described as trans. However, as before on this thread, we seem to be talking about different countries and practices.
I was checking the guidelines published by the University of California, Center for Transgender Health, and they have a section on "cultural humility", which partly involves not imposing terms and definitions on patients, and respecting the terminology used by them, which can vary a lot. There are plenty of transphobic articles online which allege that there is "fast tracking", or that children and youth are hustled into terminological and therapeutic boxes, according to some schema devised by experts. Lots of straw men really.
I'm not very happy about this. If someone is a convicted sex offender, lots of extra precautions should be taken that they do not sexually assault any other prisoners. This should happen no matter what a person's anatomical sex or gender identity is. Isolating transgender prisoners - even only those transgender prisoners who request to be removed from the prisoner population of their anatomical sex at birth - might help protect them from abuse by other prisoners, but I think it is wrong to do it in order to protect other prisoners from them.
Prisons do a terrible job at protecting the safety of inmates. Someone should be able to do their time without the constant threat of physical and/or sexual violence - from prison guards and staff as well as from fellow inmates.
Does anyone have statistics about how frequently transgender women commit sexual assault compared with cisgender men, cisgender women, and transgender men (and any other gender identities, if there are data)?
Given the very small number of transgender people, I doubt that any statistics that may exist would have any great degree of reliability as predictors of the transgender population as a whole.. They'd be just an indication of an individual case.
I'm not very happy about this. If someone is a convicted sex offender, lots of extra precautions should be taken that they do not sexually assault any other prisoners. This should happen no matter what a person's anatomical sex or gender identity is. Isolating transgender prisoners - even only those transgender prisoners who request to be removed from the prisoner population of their anatomical sex at birth - might help protect them from abuse by other prisoners, but I think it is wrong to do it in order to protect other prisoners from them.
Prisons do a terrible job at protecting the safety of inmates. Someone should be able to do their time without the constant threat of physical and/or sexual violence - from prison guards and staff as well as from fellow inmates.
Does anyone have statistics about how frequently transgender women commit sexual assault compared with cisgender men, cisgender women, and transgender men (and any other gender identities, if there are data)?
To be fair to the ministry of justice (not something I say often) trans prisoners are very vulnerable in prison - so it’s not a terrible idea. The recent case is obviously about the individual, not trans identity, but the moj now need to protect the trans prisoners from the public backlash. (Also figures for trans on others violence in the general population will be invalid for extrapolation to an imprisoned population - who have by definition a different risk profile.)
School counsellor or psychologist, he's been around for a good spell.
You could say much the same about someone expressing racist views for a long time, people understand what they see through then lens of their existing views.
Also these two professions are not equivalent, in the same way district nurse and colo-rectal surgeon are not the same - even if they are both health professionals and sometimes encounter people with the same diagnoses.
Comments
Also the Iditarod dog-sled race (Iditarod.com). 1000 miles. Women do well in it. Two have won: Libby Riddles won once, and Susan Butcher won four times. IIRC, there was talk of splitting the race into men's and women's sections, because women do so well--especially because of Susan's multiple wins.
There was talk that women have an advantage in endurance sports. This article from "Outside Online" explores that:
Q:
Are Women Better Athletes Than Men?
When my wife and I go on long runs together, she always manages to finish strong while I fall behind. Am I just out of shape, or do women have an advantage in endurance sports?
Compare male to female marathon runners. The men are faster.
If that's not enough endurance for you, how about the insane ultra-runners?
The men's track record for a 48 hour run is 473.495 km, held by Yiannis Kouros. The women's record is 397.103 km, by Sumie Inagaki.
Psychoanalysis of the Freudian variety is rare today. Very old school. But aspects of its theories have been used in most other therapies. Starting with the idea of talking to people about their inner life, and how we may play out scenarios repeatedly in maladaptive interpersonal ways.
I don't know what the solution is at the level of schools and colleges. The right wing will just want to ban trans athletes. The idea of separate trans events seems horrible.
About 15 years ago there was an unfortunate case in Canada where a trans woman tried to volunteer at a rape crisis centre and (as I understand the facts from the reported decisions) she was rejected out of hand the moment they realized she was trans. The centre went on to defend its actions in the courts on the basis that they had a right to exclude trans women from women-only spaces, a position that the courts ended up agreeing with for reasons that don't really make sense to me (15 years later, it's very possible that everything would have gone very differently from the outset).
I really do think both the centre and the courts got it wrong on the issue of principle here. That said, I can also see how even if they had given it a try, it might not have worked out for reasons that aren't really anyone's fault. It may be that as practical matter, to be an effective counsellor in the circumstances (at least back 15 years ago) the volunteer may have had to present more unambiguously as female than she was able to. But there's a need to navigate these issues in a way that respects all the relevant realities involved.
In the US we are more used to seeing ourselves as customers or patrons of healthcare, and the idea that we must take one doctor and cannot choose another seems bizarre. It's like saying I MUST go to this convenience store and not that one, for some reason or other, whether I like it or not.
I'm one of them. As much as possible, I need to have female health care providers--particularly my GP and any other that might see me less than clothed, or in a gown, or need to go poking around; but best to have females for everything else, too. It's due to many things, including #MeToo stuff. There was a time when I really couldn't cope with being treated by a male at all, even just for the beginning of the appointment interview, pulse check, etc. Some people understood that, when told. Others, including one particular woman doctor, didn't get it at all. (That woman had other issues, like supreme arrogance, not listening to explanation of symptoms I'd been living with for some time, etc.)
Anyway, after a lot of hard work and healing, I can be a bit more flexible. I'm sure there are women who prefer male doctors, even for gynecology. And there are men who prefer male or female docs, depending on all sorts of things.
I would think it normal for trans folks to want to feel safe with their health care providers. I know there are clinics here in SF for LGB folks who want an atmosphere that's especially geared for them. And I think there are some for trans folks, too.
Would she be able or should she be able?
I don't know the laws. But if she set up a specialty practice *from the beginning*, specializing in the needs of women and girls, she might manage it. I've sometimes thought that, if I were a doctor, I might do something like that.
And I think maybe some women doctors do just that in some Muslim countries.
Amd Mousethief - what is there to get or not get in posing a question for discussion?
I was thinking of say disabled woman employing personal support staff, who would possibly choose to employ female carers.
There are several GPs who are trans, I wonder if they are inundated with patients.
We have various specialty clinics in town: LGBT (and different parts of that); women's; various ethnic groups, etc. Sometimes, LB clinics will take straight women, I think, and lend out their space to groups that aren't particularly LB oriented. (Went to a health-problem support group like that, years ago.) I think the ethnically-oriented clinics generally take other people, too; but I gather the patients are almost all of the ethnic group at some of those clinics. I've heard, accurately or not, of people outside the ethnicity not only feeling outnumbered, but (reportedly) being unwelcome and being sent/driven away.
OTOH, I went to a particular ethnically-oriented clinic off and on, for a while. I checked first, to make sure they'd be ok about my being a patient. (And I would've totally understood if they hadn't been.) I was always treated well there.
As to someone's mention of people preferring a white doctor: if someone is *really adamant* about that, *everyone* might be better off if that person saw a white doctor. Saves the possibility of trouble.
I also think it's ok if people of other ethnicities don't want to see white doctors and/or only doctors of their own ethnicities. E.g African-Americans run into a lot of bias (unconscious and otherwise) from white doctors, and ignorance about various differences. That can mean bad health outcomes.
IMHO, sorting out diversity, discrimination, personal preferences and comfort, rights, etc. can be difficult to do wisely.
I agree, that seems very high. Given that trans sites here do not give any estimates (or did not when I last checked a year or so ago) is suspect that the true figure is much lower that 1%.
And thank you all for your comments. Despite what nousethief suggested, I don't have any concluded opinions on the various issues. It's easy to understand that a woman may well prefer to see a female doctor about gynaecological matters, or a man see a male doctor about eg prostate questions. I can also see that there should be no legislative limit on choice by the patient but there should be by the carer. That still leaves some fringe issues. I can't see an obligation on a medical practice to employ both male and female doctors for example. It may be better if that happens but may well be impossible to always put into effect.
That patients should be comfortable with their doctor ought to be more of a priority than the reverse (though that's good too), and there are clear cases, such as a woman who would prefer not to have to even think about harrassment and would therefore like a female doctor, where the patients choice of a category of doctor should be met. But in general I don't think choice is a right.
Well, the NHS is supposed to be about patient choice, for example, choosing a hospital or a consultant. But then it would take me 2/3 weeks to see my own doctor, so I don't mind Hobson's choice, for a same day appointment.
https://www.pediatrics.umn.edu/divisions/general-pediatrics-and-adolescent-health/programs-centers/lgbtq-youth
Sorry, I didn't think what I said was all that unclear. I'm not saying the patient has the right to DEMAND a particular doctor. But among doctors that are AVAILABLE, the patient may choose. Get it?
https://www.smithsonianmag.com/science-nature/testosterone-another-hormone-androsterone-vital-male-devlopment-180971582/
He seems to think that because he now feels shame and regret about some psychological theories he adopted - not all of which are disproved - that gender identity issues should be treated with skepticism... again, although he has no expertise to offer.
I don't understand why you think this person should be treated as authoritative when it seems to me he has no more authority about gender issues than the average person at the pub. Possibly less, depending on the pub.
School counsellor or psychologist, he's been around for a good spell. Observed. Through other non-evidence based issues touted by experts. The main point derived is that adolescent sexual issues should not be gathered into transgender by default.
Do you think he has any point at all? That there is a community which may provide an interpretation which is then adopted?
Prisons do a terrible job at protecting the safety of inmates. Someone should be able to do their time without the constant threat of physical and/or sexual violence - from prison guards and staff as well as from fellow inmates.
Does anyone have statistics about how frequently transgender women commit sexual assault compared with cisgender men, cisgender women, and transgender men (and any other gender identities, if there are data)?
To be fair to the ministry of justice (not something I say often) trans prisoners are very vulnerable in prison - so it’s not a terrible idea. The recent case is obviously about the individual, not trans identity, but the moj now need to protect the trans prisoners from the public backlash. (Also figures for trans on others violence in the general population will be invalid for extrapolation to an imprisoned population - who have by definition a different risk profile.)
You could say much the same about someone expressing racist views for a long time, people understand what they see through then lens of their existing views.
Also these two professions are not equivalent, in the same way district nurse and colo-rectal surgeon are not the same - even if they are both health professionals and sometimes encounter people with the same diagnoses.