[RD] Trans Genocide

[sophie]

The rate of regret for a knee replacement is anywhere from 6-30%. The rate of regret for having children is around 8%. The rate of regret for Lasik is 5%. The rate of regret for a sex reassignment surgery is about 2%.

 

[Angst]

Being ill and benefiting from treatment are definitely perceived as different concepts. It's kind of amusing, actually. No one thinks of short-sighted people as ill, although they benefit from laser eye surgery. And a person with a cancerous tumor is definitely thought of as ill once they are on chemotherapeutics, but whether we think of them as ill before and after a successful surgery, I just don't know...

We hope that the treatments help return someone to an acceptable baseline of health or capacity.

"Ill" might be a degradation from a previous more healthy state?

this is a real problem. and sorry about this trans people in this community but i'm kind of ambivalent as to the push for gender dysphoria to not be classified as a mental illness.

the thing is, imo, it's an ailment that can and should be treated. not by treating it wrongly but by gender affirming care, whether it's medicine, therapy or surgery.

the problem of course is that being ill... illness is something people consider dirty. and some people want the dirt removed by quite inhumane means.

again, i am schizophrenic, and that's bad. but i'm not dirtier for it. i just need treatment. and people with gender dysphoria have a roster of options to actually get cured to a reasonable degree at least. (edit: by that i mean we have the technology, not the access.) i'd kill to be able to have surgery and get my schizophrenia gland removed. well i wouldn't kill... you know what i mean. the point is that there's nothing wrong with you for being ill.

it's awful of course because i understand the push to not consider it an illness. more because of the political environment. because the people that consider it dirty do so to such a degree that you're actively threatened by your fellow citizens. on your life, sometimes.

it's just sad. it should be like eyesight. understand that the body has an ailment and just allow people the damn glasses.

 

[Lexicus]

LMAO Sorry but I have absolutely no idea what to make of this.

He means this is clearly the first step in an escalatory process

 

[El_Machinae]

I won't have the citations. My warning at the statistical level is that any numbers are from outcomes with yesterday's gatekeeping. Well, and transition into yesterday's society.

 

[Angst]

The rate of regret for a knee replacement is anywhere from 6-30%. The rate of regret for having children is around 8%. The rate of regret for Lasik is 5%. The rate of regret for a sex reassignment surgery is about 2%.

more proof what this is really about. ):

 

[IglooDame]

The rate of regret for a knee replacement is anywhere from 6-30%. The rate of regret for having children is around 8%. The rate of regret for Lasik is 5%. The rate of regret for a sex reassignment surgery is about 2%.

"But if we didn't mandate so much gatekeeping, that 2% of irreversible life-altering surgery might go all the way up to..." what, 5%? 10%? 2.1%? Bleh.

Edit: El Mach beat me to it, sorta.

 

[sophie]

this is a real problem. and sorry about this trans people in this community but i'm kind of ambivalent as to the push for gender dysphoria to not be classified as a mental illness.

What do you mean by this? I don't think there are trans people who would deny that gender dysphoria is an illness. The problem we have is with the equation of transness with dysphoria. You do not need to have dysphoria to be trans. You do not need to take hormones or undergo gender-affirming surgeries to be trans.

I think the parallel would be with neurodivergence? My having adhd is not a disease. And the purpose of treatments I receive is not to "cure" me of my neurodivergence or make me neurotypical. The purpose is to manage those symptoms which are debilitating to my daily functioning. Neurodivergence is a part of who I am, and I don't appreciate the suggestion that who I *am* is somehow ill or in need of curing or suppression. It's the same with being trans. Being trans is not an illness. But one consequence of being trans (thought not a necessary consequence) is having dysphoria, whose symptoms I treat with medication. I have an illness; I am not ontologically ill. My existence is not a sickness or a contagion, that way lies the language of the genocidaire.

 

[Angst]

What do you mean by this? I don't think there are trans people who would deny that gender dysphoria is an illness. The problem we have is with the equation of transness with dysphoria. You do not need to have dysphoria to be trans. You do not need to take hormones or undergo gender-affirming surgeries to be trans.

I think the parallel would be with neurodivergence? My having adhd is not a disease. And the purpose of treatments I receive is not to "cure" me of my neurodivergence or make me neurotypical. The purpose is to manage those symptoms which are debilitating to my daily functioning.

i didn't know the first paragraph. which makes me feel like an idiot. i've looked into trans issues for a long time (queer myself with some dysphoria) and for some reason i've missed a big part of the puzzle.

my questions started some time ago when danish psychiatry removed transgenderedness from the illness list. but i understand now that transgenderedness does not mean tou have dysphoria.

but i know about hormones etc being an option and not the whole picture btw. i tried to be clear as possible about that in my post. the point was basically that if you need treatment, you should have it. and that you shouldn't feel dirty for needing treatment.

but yea it becomes less applicable in a bunch of cases with your first paragraph.

edit bugged and posted before done. editing. moment.
edit DONE

 

[IglooDame]

Exuberance colors the post but I endorse you encouraging and training those near you in the empowering art of using long arms.

Could have used you for this thread a couple years back where break with the US left and endorsed mass armaments to push back on rightwing confidence. And specifically armalites for interoperability.

I appreciate your thoughts, but need to fess up - and no little irony in the fact that a couple months ago I pushed back on my local PP group, saying that I was there to help people with pistols and personal self-defense, but if it got militia-ish I'd probably fade out. I don't even own any long guns of any significance. "Armed gays don't get bashed" is still my thing. Frankly to me, the point at which any 'militia' shows up typically means overwhelming government response, and/or violent civil disorder meaning it's no longer an LGBTQ thing but a democratic government thing.

All that said, after Florida just started detransitioning everyone on Medicaid/Medicare, I'm now looking into buying my first AR, and none of this hello kitty stuff.

 

[sophie]

but i know about hormones etc being an option and not the whole picture btw. i tried to be clear as possible about that in my post. the point was basically that if you need treatment, you should have it. and that you shouldn't feel dirty for needing treatment.

but yea it becomes less applicable in a bunch of cases with your first paragraph.

edit bugged and posted before done. editing. moment.
edit DONE

Certainly, I think the other side of this, to the extent that trans people might want to disrupt the direct connection between dysphoria:illness :: hormones:treatment, is because most trans people want hormones for reasons other than/in addition to directly treating dysphoric symptoms. HRT has been profoundly transformative for my life and my general mental state. But I took it because I wanted my body to stop looking so masculine and because getting misgendered constantly was really getting to me. So the process of imposing gates and gatekeepers turns into a sort of metagame. Because of the nature of the gatekeeping, trans people, generally speaking, have to know the WPATH recommendations, the different drugs, their advantages and disadvantages, dosing, course of treatment, and dysphoria as a medical diagnosis inside and out like the back of their hand, and they will spend months meticulously reading all the studies and getting advice from other trans people before they even schedule their intake appointment. They frequently know a lot more about it than any of their doctors do. So it becomes a game: I have to say the right combination of words that I know you're listening for so that you will give me a prescription for the drugs that I know I need, as if I mess up or mispeak or overshare there's a chance that you might not give me the drugs, or else might give me the wrong combination or wrong dosage.

 

[Cloud_Strife]

For me personally during my worst episodes of dysphoria, being trans is almost like hell, to say nothing of the social discrimination that comes from it.

I feel so alone in this world, so isolated from myself that even my own body feels more like a flesh suit that was ordered in the wrong size and sex than something i can fully cherish.

Trans people's rate suicidality, self harm etc increases the more intolerant a society is, the more people deny trans people basic dignity and humanity; that's why misgendering is a form of denial of humanity; it takes what little i have, my identity who i am, and discards it whilst telling me that i'm wrong.

It's really no different than when society tried to tell gay people that they were/are delusional and that they are actually straight.

 

[Angst]

Certainly, I think the other side of this, to the extent that trans people might want to disrupt the direct connection between dysphoria:illness :: hormones:treatment, is because most trans people want hormones for reasons other than/in addition to directly treating dysphoric symptoms. HRT has been profoundly transformative for my life and my general mental state. But I took it because I wanted my body to stop looking so masculine and because getting misgendered constantly was really getting to me. So the process of imposing gates and gatekeepers turns into a sort of metagame. Because of the nature of the gatekeeping, trans people, generally speaking, have to know the WPATH recommendations, the different drugs, their advantages and disadvantages, dosing, course of treatment, and dysphoria as a medical diagnosis inside and out like the back of their hand, and they will spend months meticulously reading all the studies and getting advice from other trans people before they even schedule their intake appointment. They frequently know a lot more about it than any of their doctors do. So it becomes a game: I have to say the right combination of words that I know you're listening for so that you will give me a prescription for the drugs that I know I need, as if I mess up or mispeak or overshare there's a chance that you might not give me the drugs, or else might give me the wrong combination or wrong dosage.

just reading this hurts my brain. can't imagine what it's like when you need treatment on top of it.

like, it's still a medical issue. dysphoria or not. and we have the technology. society should provide it. it should not be up to the patients to learn it.

 

[Cloud_Strife]

All i have is my internal identity, i don't even have my own body and to deny that, is to reduce me to nothing, it is to deny my humanity or to attempt to diminish it imo.

I am not my body, I am not my birth sex, I am a woman and if you call me male, tell me in whatever sly euphemism you can find that I'm not a woman i will take that as a direct attack against me and respond accordingly.

 

[El_Machinae]

"But if we didn't mandate so much gatekeeping, that 2% of irreversible life-altering surgery might go all the way up to..." what, 5%? 10%? 2.1%? Bleh.

Edit: El Mach beat me to it, sorta.

The knee replacement number is a good example, even if it's not completely analogous. But that number will be the combination of perverse incentives by providers, insufficient education for the patient, and the fact that the medicine is really difficult.

The failures of the analogy will be that knee replacement surgery is a later event and also has a reasonable personal responsibility portion. Some people choosing knee replacement will have made subpar choices in their past.

All else being equal, the number of regretting transitions will increase if perverse incentives are not prevented, the techniques don't improve, or if people misguess how the future will treat them. Overtreatment is a standard outcome in medicine, so to not expect it here is just wishful thinking. More importantly, I think the consequences of any mistakes on this front might be politically risky, because I don't think progressives can make political progress in time.

Balancing type 1 errors and type 2 errors is always a dilemma. But there will also be easy ways of trimming either back without significantly impacting the other. Ideally, you want experts involved in gatekeeping, and you want to make sure both that they have proper incentives and aren't disincentivized.

Brutally difficult, given the political controversy and youngness of the medical science. I mean, we even screw up C-section services.

 

[emzie]

Overtreatment is a standard outcome in medicine, so to not expect it here is just wishful thinking.

I'll testify to this. I had sex reassignment surgery in January, and I have some regrets. The surgery was more complex and brutal than I needed it to be. I don't wish to undo it, now that it's done. I don't think I would have known it was more than I needed had I not gone a step too far, but having gone a step too far, I can say that it was harmful.

 

[El_Machinae]

Also, because it's so politically controversial, let's remember who can influence the Younglings. No younger patient is going to trust my opinion, unless they know me personally.

We are going to undergo a shift in variance when it comes to type 1 and type 2 errors, so allies making sure that they have the incentive for healthy outcomes among the other members of the community is vital. It's also a political movement, which makes it very hard, because political movements require short-term converts.

Talking in terms of DALY and statistical error is very cold. The goal is to increase the number of successful treatments. And there is a opposite movement where successful treatments is not a goal, but denying them is. Coupled with this really weird subconscious incentive to have failed treatments. Mind you, mistreating visibly trans people is a very powerful way of making people regret transitioning. They know that, even if subconsciously they don't tell themselves that

 

[Kyriakos]

The mistake, I think is in trying to imagine yourself as or becoming "the other gender." Because when you do this you are not imagining what transness feels like, you are imagining what it would be like "if I were trans" if that makes sense. To understand transness I think it'd help to go more absurd, to take your mind away from familiarity. So instead, imagine a Gregor Samsa scenario. You are precisely the same person you are now, only one day you wake up as a giant cockroach. Every part of you feels completely alien. It feels wrong. You feel like you were not built for this world. Every moment of existence is a stark reminder of this alienness. You try to roll over in bed but your hardened carapace can no longer balance on its side. You try to walk upright, but you cannot, and are forced to crawl around on the ground like a dog. Movement itself is utterly humiliating. Every door you go through you get wedged. Every time you catch your reflection you become physically nauseous. You can no longer feel warm water when you take a shower. You see visible looks of alternatively disgust or pity on the face of every person you meet. Your parents are embarrassed by your existence, they barely talk to you. They won't even look at you. You are jostled and stepped on constantly as you scuttle down the street, your wide girth presenting an obstacle and an eyesore to passers by. You try to have sex, but everything just feels wrong. You don't even have a penis anymore. You feel like an unlovable pest as your 6 legs flail about impotently. You fear you will never be able to feel sexual pleasure ever again. There is never a moment in which you are not palpably reminded that you are a disgusting hideous bug. You are reminded every time you try to put on clothes and they immediately tear to shreds, by your inability to manipulate the buttons, by the grotesque way the shirt strains against your girth, while the pants are at once somehow too small to clasp around your abdomen, but also too long and 75% of the leg lies comically on the floor. You are reminded every time you reach for the milk and it falls to the ground because you no longer have hands. You are reminded every time you eat your food off the floor, unable to chew or taste, but only to pass food through your mandibles and down your gullet.

Now imagine that this is not your existence for an hour or a day or a weekend. This is how it will be forever. You will always be a cockroach. The horror will never stop. You will not acclimate to this, because in your mind you will always know and remember that you are human. The forgetting that you don't have hands and the feeling of utter despair when you drop the milk for the 5th time this week, it's contents splattering across the floor again, will always be the same. The feeling of total degradation at having to scuttle across the floor each morning will always be the same. This will be your existence until you die.

That's what gender dysphoria feels like. It does not feel like waking up the "wrong gender." It feels like waking up in a wholly alien body, where everything you do, even things you would otherwise like, feels completely wrong, and that wrongness renders you incapable of enjoying even those small creature comforts. One of the biggest commonalities among trans people before they hatch is the feeling or sense that they are not of this Earth. That they are an alien creature who was smuggled down here at birth, and that somehow everything on this planet is askew, as if it were not made for them. If you want to understand transness, and the feeling of dysphoria before coming out, the insight won't come from fetishistic transformation material. Trans media is body horror.

Interesting. Then again the Metamophosis can be seen as a metaphor for a lot of things, and one has to assume it is certainly a metaphor for Franz Kafka's sense - of whom it is entirely known (diary notes) that he had BDD (also hypochondria), but nothing substantial there to claim he identified with a different sex than was assigned to him (not impossible, I just can't think of any supporting text).
I won't try to nit-pick (I mean, it's the Metamorphosis, of course I have comments ), and overall I liked your take of it.
Feeling you are not "of this world", for example, is certainly entirely valid a summation of what is going on there. But the change of movement (alien moves), while a very good metaphor for what you say, in the text refers also to the factor of "added complexity" (Samsa now has to do great calculations, so as to move; remember that he has the legs of a milipede and the body of a beetle). That can, in theory, also just refer to posturing/trying to stay safe (in context he has to do those moves also to avoid being hit by his father), but it more than likely ties the meaning of the Metamorphosis to a mental change related to pronounced introversion, and a sort of collapse in that cavern (this is entirely supported by Kafka's thousands of pages of diary and letters too). In this way, the meaning of the complicated moves for things others find very simple and do automatically, appears to present the same point as Baudelaire's famous Albatros poem (when the Albatros falls to the deck, it is no longer majestic but pitiful, since it is made for flying etc).

I view Gender Dysphoria also by proxy, since I am not trans. To me, intuitively (trying to find the closest thing I know) it seems to be similar to BDD, which also has suicidal ideation and can lead to suicide.

Of course, on the topic of needed drugs, I am all in favor of the state supplying them. Sadly the state often doesn't want to, even when it is sufficiently rich.

For a long time now, long before I realised that I'm trans, I've been thinking about werewolves. The idea that a human transforms into a wolf and becomes a monster. The depiction is that the wolf is the monster but I've long thought that maybe it's not that the wolf is the monster, it's forcing the human into a form that's not their own and the only way they can cope is by acting like a monster, like an instinctive reaction against their new form.

This is an excellent post, imo. So the monster-pretension is borne out of the expectation of others that you agree to be something that you view as monstrous but can't tell them outright what you view, out of fear they will feel offended (since they are what you identify as monstrous, and you feel guilty of that). Again, I can't (personally) comment as to how crucial it is to trans, but it definitely has application to BDD.

 

[sophie]

Thanks for the commentary . I was mostly using the scenario as a jumping off point (rather than talking specifically about the literal Kafka story), to try to break Yeekim away from imagining being trans as a voyeuristic genderswap story, which I think is usually where the mind goes if you try to imagine transness or dysphoria as "yourself, but with boobs." The calculated movement piece is one thing I hadn't considered, but I think it is a feature in transness too. We spend a great deal of time trying (and failing, miserably) to pantomime being our assigned gender. It requires a great deal of strain to do so. But one thing I wanted to emphasize in my description is that the reminder of the presence of that strain, the confrontation with the absence, renders the effort and the strain and discomfort from the effort the more excruciating. It is not just that I have to work harder to do things that should be straightforward, but that every time I have to think about the basic thing I am reminded that it is not basic for me (when it should be), and it is not basic for me because I have these fudging insect legs instead of hands. So you get double jeopardy: the burden of the calculation, and the anguish that comes from being reminded of the need to calculate.

I think one big part that it seems is missed a lot is the ceaseless nature of the dysphoria. I can describe the condition, the symptoms, and the experiences, but I think for neurotypical cis people the way they imagine it is as a discrete chunk of time. There is an assumed point where the "experience" stops and they get to go back to the mental frame of being cis. In my experience, this part of it is a lot easier to get across with ND people because, as with dysphoria, the OCD, the BPD, the ADHD, etc. is there. All. The. Time. It doesn't stop. In therapy I frequently described my dysphoria as like sitting just a little bit too close to a heater that is set just a little too high. You're stuck there and you feel the heat hitting you, and you get hotter and hotter and hotter, until it enters your consciousness and then you get into a negative feedback loop where you're aware of the heat which makes the heat feel more eminent which makes you feel greater discomfort from the heat which makes the heat feel...etc. And there is no escape. You are chained to the chair and the heater is locked in its position. You do not get to stop. You do not get to walk away. You do not get to turn the heat down. There is nobody to help you. That's what it feels like. Like you are being dispassionately, impersonally tortured with no end in sight. With nobody you can appeal to for respite. That's what drives people to do things like spend $5000 for the privilege of sitting while a person inserts an electrified needle directly into every single hair follicle on their face for 120 hours. That treatment adds a foot of slack to the chain. After decades before the fire, I would do whatever it takes to give myself even an inch's respite.

 

[Cloud_Strife]

I wouldn't wish dysphoria on my worst enemy, not even the people who hurt me so much.

 

[Kyriakos]

Thanks for the commentary . I was mostly using the scenario as a jumping off point (rather than talking specifically about the literal Kafka story), to try to break Yeekim away from imagining being trans as a voyeuristic genderswap story, which I think is usually where the mind goes if you try to imagine transness or dysphoria as "yourself, but with boobs." The calculated movement piece is one thing I hadn't considered, but I think it is a feature in transness too. We spend a great deal of time trying (and failing, miserably) to pantomime being our assigned gender. It requires a great deal of strain to do so. But one thing I wanted to emphasize in my description is that the reminder of the presence of that strain, the confrontation with the absence, renders the effort and the strain and discomfort from the effort the more excruciating. It is not just that I have to work harder to do things that should be straightforward, but that every time I have to think about the basic thing I am reminded that it is not basic for me (when it should be), and it is not basic for me because I have these ******* insect legs instead of hands. So you get double jeopardy: the burden of the calculation, and the anguish that comes from being reminded of the need to calculate.

I think one big part that it seems is missed a lot is the ceaseless nature of the dysphoria. I can describe the condition, the symptoms, and the experiences, but I think for neurotypical cis people the way they imagine it is as a discrete chunk of time. There is an assumed point where the "experience" stops and they get to go back to the mental frame of being cis. In my experience, this part of it is a lot easier to get across with ND people because, as with dysphoria, the OCD, the BPD, the ADHD, etc. is there. All. The. Time. It doesn't stop. In therapy I frequently described my dysphoria as like sitting just a little bit too close to a heater that is set just a little too high. You're stuck there and you feel the heat hitting you, and you get hotter and hotter and hotter, until it enters your consciousness and then you get into a negative feedback loop where you're aware of the heat which makes the heat feel more eminent which makes you feel greater discomfort from the heat which makes the heat feel...etc. And there is no escape. You are chained to the chair and the heater is locked in its position. You do not get to stop. You do not get to walk away. You do not get to turn the heat down. There is nobody to help you. That's what it feels like. Like you are being dispassionately, impersonally tortured with no end in sight. With nobody you can appeal to for respite. That's what drives people to do things like spend $5000 for the privilege of sitting while a person inserts an electrified needle directly into every single hair follicle on their face for 120 hours. That treatment adds a foot of slack to the chain. After decades before the fire, I would do whatever it takes to give myself even an inch's respite.

One last thing (Columbo-style) about the Metamorphosis as a metaphor here:
That story begins with Samsa not trying at all to change his new state. For half a page he daydreams that it may go away on its own, but he never returns to thinking of what caused it, even later on when it is clear he is led to suicide. I think this allows one to infer that Samsa knew (or at any rate had an idea) what caused the metamorphosis, but it was simply too difficult to deal with, so he preferred to hope that the manifestation/symptom would go away again.
So there are problems with viewing that transformation or state as something (in the story) one is consciously combating. It appears to be more of an unexpected, stronger spell of a known problem one had decided to live with (of course, that Samsa did accept all that, in no way helped him; probably if there was any hope to go back to feeling he is human, it'd be through examining the causes, which as I mentioned is literally the last thing he wishes to do).