Ruth Institute Blog

Way to have compassion and empathy for people whose physical sexual characteristics don’t match their gender identity. Having known a few of these folks myself, all I can say is shame on you.

One thing that really puzzles me is the response of the medical or psychological profession to “transgenderism” or whatever it’s supposed to be called.

I’m genuinely puzzled. Perhaps somebody who knows could respond.

Anyway, why is it that people who show one type of dissatisfaction with their body told that their best option is surgery, and others we tell them “stop it!” (See: )

Anyway, for a person who is convinced that he is a woman born into a man’s body, he seems to get the advice that he should get his male genitals amputated and replaced with a non-function facsimile of female genitals. (Vice versa for females with the opposite problem).

Yet, for anorexics, who are also people who are dissatisfied with how their bodies look, work, etc, we tell them “stop it.” We do not recommend that they undergo an intense regimen of liposuction to give them the appearance of thinness…

The reason I’m asking is because I wonder (truly wonder) if the surgery would really make the person happier. (Before you tell me “Yes, I’ve met transsexuals, and they’re much happier after surgery” I would suggest reading “Stumbling on Happiness.” The sections about self reporting of happiness and how the happiness has improved after certain events are relevant here).

I’m not sure that transgendered individuals are given the advice of reassignment surgery. From what I understand about it, these individuals are the ones begging for it. I cannot imagine what it must feel like to identify as one gender and be born into a body with sex characteristics for the other gender. How terribly sad, confusing, and infuriating such a condition must be. I remember a woman in college who was actually born a boy. That is, she had external male genitalia at birth and no one questioned her sex, although she will tell you that she always felt female. Then puberty hit, and she started growing breasts, and it was discovered that she also had internal female sex characteristics (ovaries and a uterus). Tell me, what would you have counseled her parents to do? Allow her to be the female that she believed she was, or treat her as a male because she had a penis?

Did she make me feel uncomfortable at first? Yes. She was a woman with many male characteristics, including standing over 6 feet tall with broad shoulders! But she was and is also a human being, deserving of compassion and respect. Although she was born intersexed, and thus had physical manifestations of both genders, is it that much of a stretch to understand that sometimes the brain and the body don’t match. I think this is vastly different from the issue of body dymorphism or anorexia. The body of an anorexic may not be the size or shape that he or she wants, but it is not the same as having a body that fails entirely to match one’s conception of who he or she is as a person.

There are several undeniable facts about human nature that need to be addressed here:

1) Human beings have a certain base level of happiness. Different for every person. During the course of people’s lives, they tend to stay somewhere around that level of happiness.

2) People are terrible at predicting the future.

3) Like any prediction of the future, people are not good at predicting how future events will affect their happiness for good or for ill.

All of these factors conspire to convince me that people who are unhappy with their bodies (for whatever reason) will not suddenly become happy if their bodies changed to exactly what they want them to be. I fail to see how transgenderism should be any different.

People don’t get a lot happier long term if they suddenly get lots of money. They don’t get happier if they win medals and awards. They also don’t get, long term, unhappier if they gets seriously injured or lose dear ones. Long term, in all of these cases, they return to about their average level of happiness. That’s just how the human brain works.

Ari,

I suspect you might hear a different story from the mouths of transgendered people themselves who have undergone the surgery and who have acquired the external body that matches their internal identity. From what I have read and learned about the topic, it is a very liberating and affirming experience for these individuals. Don’t assume; get to know a few of them. They have important stories to tell if people are willing to forgo their self-righteous judgment long enough to really listen with compassion. Learn to see these individuals as human beings, not as freaks of nature or as psychologically disordered misfits. They have a lot to teach us all about the complexities of sex, gender, sexual orientation, gender identity and the like. I look on them now with such compassion, because I cannot imagine the persecution each one has faced, and the courage it takes to be who they believe they were born to be, especially in such a hostile and cruel world.

Heidi,

Your late comment sounds logical. But it seems to be contrary to the facts. I would suggest reading Chapter 2 of Stumbling on Happiness. It deals with conjoined twins and their thoughts on getting separated. Prof. Gilbert discusses how reliable their reports of their happiness in their current state is and how reliable their statements would be if they got the surgery to separate them. Suffice it to say that I would no more rely on the statements of a transgendered person about his new body than I would rely on the statements of conjoined twins on their new separate bodies.

There is an additional set of reasons to be skeptical of a person’s chances of long term happiness after they get “transgender surgery” That is because people have a tremendous pressure to be true to their past selves. I, for instance, have a pair of shoes that I spent decent money on. They’re uncomfortable. But I keep them anyway. Why? It’s illogical, but I guess it’s because if I don’t want to admit to having made a mistake. Getting rid of a barely worn pair of shoes would be just such an admission. Item #5 of this funny article discusses why:

http://www.cracked.com/article_18388_6-logical-fallacies-that-cost-you-money-every-day.html

I forget what the scientific name for the phenomenon is.

Do you really expect any transgendered person, no matter how miserable they still might be in their “new bodies” to tell you “gee, I guess I was wrong about wanting to have the amputation?”

Lastly, you might also want to consider how their happiness would be when taken in the long term. I doubt it would be much different than it would be without surgery. People are resilient. They can learn to accept reality and move on. That might be a more reliable way to achieve happiness.

I did not call “transgendered” people freaks or anything of the sort. I don’t see why you’re accusing me of that.

Lastly, on this and on one of your previous comments you suggested I talk to “real people” rather than base my policy suggestions on statistics. Surely people are not statistics. I agree. But when dealing with policy that affects large numbers of people, the only choice is to deal with statistics. Like in a casino, some people beat the odds. But there’s a reason that Vegas can build grand palaces of decadence. It’s because most people do not beat the odds. Statistics work when you deal with large numbers.

I don’t know if anyone is still reading this, but I can speak from several perspectives on this issue, including as a health professional who has been involved in the care of both transgender and transsexual patients.

First of, though, some definitions. Trangender individuals subscribe to a spectrum of gender, and they exist in the space between male and female. Transsexuals generally subscribe to the binary view of sex, they just see themselves on the opposite pole as that held by the physician who wrote M or F at birth. Transsexuals can support and empathize with transgender people, but their internal worldview is as binary as anyone comfortable with their birth documented sex.

There are also intersex individuals. People with anatomical or biological traits of both sexes. Intersex people can also fit into transgender or transsexual categories depending on the circumstances.

Arlemagne, are you still monitoring this?