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New Survey of Detransitioners – Participants Wanted

*Survey closes on April 30*

Hi,

I’d like to announce recruitment for a new research study designed to better understand the experiences of people who have undergone gender de-transition. For the purpose of this study, gender de-transition is defined as having undergone gender transition related medical procedures (hormones and/or surgeries) and then subsequently de-transitioned. The study is an anonymous online survey. Take a look at the recruitment information and if you are interested, follow the link to the study. Please share the recruitment information and link with anyone you think might be interested and eligible.

Thanks,

Recruitment Information

Study Title: Individuals who received medications and/or surgery for sex reassignment and then de-transitioned: a descriptive study

Gender dysphoria, discomfort about one’s biological sex or assigned gender, is often treated with medications and/or surgery (also called transition). Some individuals choose to “de-transition” by stopping medications and/or having survey to reverse the effects of transition. The purpose of the study is to describe a population of individuals who experienced gender dysphoria, chose to transition by taking medications and/or having surgery, and then de-transitioned (by stopping the medications or having surgery). We are interested in individuals who have de-transitioned, whether they feel positively, negatively, or neutrally about their decision to transition and the time they spent transitioned before de-transitioning. This research study is being conducted by Lisa Littman, MD, MPH, Adjunct Assistant Professor, Icahn School of Medicine at Mount Sinai.

Previous research shows that the satisfaction rates for transgender individuals who transition is generally high and the regret rates are low, though little is known of those who describe unsatisfactory experiences with transition or de-transition beyond accounts available on social media. An informal survey on social media yielded over 100 surveys from de-transitioned individuals in only two weeks of recruitment. Given that this population exists and has not yet been described in the medical literature, this research is needed to describe this outcome, to generate hypotheses, and to assess the psychological and social needs of persons who have taken, or are considering, this decision.

This survey is completely anonymous and confidential and conducted through Survey monkey, an independent third- party. There is no way to connect your name with your responses. We do not track email or IP addresses. Please do not write in any identifying information about yourself in the open text boxes. The survey should take 30-60 minutes. Participation in this research study is voluntary, and you may refuse or quit at any time before completing the survey. If you know of any individuals with a similar experience who might be eligible for this survey, or any communities where there might be eligible participants, please copy and paste this recruitment information and survey link to share.
Survey Link: https://www.surveymonkey.com/r/VZLBVJ3

Trans or just a fetish?

The question “Am I trans or is it just a fetish?” has to be one of the most common questions that is asked by people considering MTF transition. This question shows up over and over again on reddit’s r/asktransgender and other transgender forums. They almost always answer “yes, you are trans” and there is even this handy website to determine whether you are transgender or not. (Always yes!)

I think it is very important to deconstruct this question and analyze it as I think it explains some of what is going on around this issue. First, there is an implied hierarchy. One can either be trans or “just” have a fetish. The word “just” implies that this is a lesser state. Also you “are” trans but “have” a fetish. One of these things is an identity, and the other is a stigmatized mental illness. I know I would prefer to be something than to have a mental illness! There is also an implied either/or to the question. One is either trans or just has a fetish, not both. I’m not saying that having a fetish is a mental illness, just that is what is implied by the word.

People with trans identities are definitely stigmatized in many contexts, that is true. However, there are certain subcultures where being trans can be considered positively, perhaps in some queer, academic or liberal contexts. In nearly all contexts being viewed as a woman with an unfortunate issue with a wrongly sexed body, is much less stigmatizing that being viewed as a man with a fetish. This adds to the view that being trans is a more desirable state than “having a fetish”. Even in the fetish/kink community itself cross-dressing is considered one of the lower status kinks to have.

This hierarchy has existed in the trans community in a long time. Kate Bornstein wrote about it the 90s. Post-op transsexuals were at the top of the the hierarchy, followed by pre-op transsexuals, and then transgenderists (which at the time was not an umbrella category but instead was a state intermediate between transsexual and transvestite), followed by transvestites, and then fetishistic cross dressers at the bottom. This hierarchy creates a bias towards identifying as trans vs. “having a fetish”.

A larger problem is that emotionally charged words like “fetish” leads one into the realm of moral reasoning. In moral reasoning, things are good or bad, as opposed to analytical reasoning where things are true or false. Moral reasoning activates tribalism and divides us to moral tribes. When two opposing moral tribes discuss an issue it can be difficult to impossible to find compromise. The discussion of trans issues in an objective way becomes very difficult because there are factors on all sides that throw the discussion into the realm of moral reasoning. On one side there is the use of stigmatizing terms such as “autogynephilia” and “fetish” which are sometimes used by enemies of trans people to shame them. On the other side there is the use of social justice ideology which also throws things into the realm of moral reasoning. Once one side uses moral reasoning, the other side than also veers into moral reasoning and communication stops. Moral reasoning also trumps analytical reasoning which means that analytical reasoning tends to stop when moral reasoning is invoked. A good sign that you are in the realm of moral reasoning is when you believe that the “other side” is 100% wrong about everything, whether this be liberals, conservatives, men, women, trans activists, radical feminists, or who ever else. I recommend reading my favorite social psychologist,  Jonathan Haidt if you want to learn more about this issue.

My general view is that you don’t choose to have these thoughts and feelings but do have some ability to choose what to do with them. Some people have more ability to choose than others depending on their particular circumstance, this depends on the intensity of their feelings, the psychological circumstances that surround things, as well as their personal temperament. In many cases the “fetish” will be far less disruptive and be manageable. Transition creates many difficulties as well, and does not cure dysphoria, it only manages it. I think it is better thought of as a chronic condition that can be managed in a variety of ways, and the task is to figure out the best way according to your own circumstances. Also not only is term “fetish” stigmatizing it is incomplete, as there are often deeply meaningful psychological components attached as well and it is not usually just a sex thing.

This phenomena can itself be divided into several different parts some of which have the potential to cause problems others of which do not. Part of it all is simple fantasy. Fantasy itself is not harmful, and also cannot be controlled. We fantasize about what we fantasize about, and lots of people have all kinds of strange and wonderful sexual fantasies. This is just what happens when our modern brains intersect with our primitive sexual instincts. Fantasy itself is never a problem, it is only when it becomes combined with something else that it is a problem. Even for those with particularly unfortunate sexual fantasies that would cause tremendous harm to enact, the fantasy itself doesn’t harm anyone. Also, trying to prevent thoughts doesn’t usually work, and only strengthens them.

One example of when it becomes a problem is if it develops obsessive qualities or becomes compulsive. Another is if impedes the ability to form relationships. Yet another is if it causes one to violate the boundaries of others in some way.

If it is used as a coping mechanism, this can be okay in moderation. However, like most coping mechanisms there is a tendency to escalation and requiring more and more of the “drug” for the same effect.

Also, it can be tied into psychological needs. Sometimes it is tied into an experience of an “inner woman” which some people who experience this phenomena have. Jack Molay writes about this here and here.

I think Jung’s writings on the anima are very relevant here. Jung described working with the anima as important to the psychological growth as those qualities can be integrated and produce growth. The anima can be an important guide. However, Jung simultaneously warns about the phenomena of “anima possession” where a man can become taken over by the inner woman. It was actually reading Jung and his phenomena of anima possession which first knocked loose my transgender identification.

In summary, a “fetish” or cross-dreaming are not lesser states to transgender identity. This idea can lead to preferring transgender identity which could potentially be far more disruptive to one’s life. Also, shame over sexual motivations can specifically lead to the preference for a transgender identity over other possible outcomes. This is a place where trans critics sometimes go wrong, by specifically shaming the sexual aspects of trans identity, they may be creating more of the very phenomena they oppose.

For some more related reading I recommend this essay by Ozy “Trans as Choice” and this essay by Angus Grieve-Smith “On the Slippery Slope”

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Identity is not the same as authenticity

I have been again thinking about identity, because it seems to lie at the heart of all the recent discussion of transgender issues. I have also been thinking about how the way we treat identity with respect to gender dysphoria is very different from that with other conditions. In fact, the way we treat identity with respect to gender dysphoria is the polar opposite of the way we look at most other conditions. In many different contexts, I was taught the importance of not making an identity out of someone’s condition.

For example, we try not to say “schizophrenic” instead we say “person with schizophrenia”. We try not to say “a depressive” and instead say “person with depression”. However, with gender issues it is the reverse, we are encouraged to say “trans person” rather than “person with gender dysphoria” and also to affirm those identities.

The reasons for this disidentification process are several. One is to avoid distorting our perception of the person so we do not see them as just their condition. We must remember that they are so much more than that. Another reason for this practice is to avoid stigmatizing them, so they are not seen as being just that particular condition, they are a full dynamic human being with many different parts

Another reason for this, relates to the person seeking to work with their condition themselves. When someone identifies with something it becomes frozen. It is much harder to treat someone for depression if they identify with it. If they say “being depressed is just who I am, it cannot change.” that is much harder to work with that than someone who says that they “have depression”. One technique for those who are too identified with their depression is to externalize the depression. We try to get them to see the depression as not their whole self, and to perhaps say “that is the depression talking”. This tries to bring their whole self into the picture, rather than just the depression, as the rest of the self can get lost when an identity is formed.

I have talked about identities as self-concept in the past. However, another important aspect of identity which I neglected is group identity. A lot of identities involve identification with a group. When people talk about identities they are often talking about things like race, class, national identity, political identities and certainly gender. Group identities divide us into groups. They say who is “us” and who is “not us”. The desire to be part of a group is a very basic human desire. We are tribal creatures. However, when group identities come into play, they tend to override objective reasoning. There is a sense that our group is right and the other group is wrong. Reason is no longer used to explore the truth, but is instead used to support our moral position. Arguments become moral, rather than rational, and moral reasoning trumps objective reasoning. This is part of what makes discussion of trans issues so difficult. Identity comes into play, and discussion becomes very difficult.

Another problem with group identities is that they can result in a loss of individuality. Connecting with a group and being a part of a group can be such a good feeling, especially if it is a group of people that reflects parts of oneself that have not been reflected before. A lot of my own impulse to transition 20 years ago arose in part from my encounter with the community. It felt so good to encounter people that shared the same feelings about gender that I did, as my gender feelings felt like a deep secret that I would never share with anyone and did not share with anyone “real”. Talking to people who had the same feelings and could relate to my experience was so great. I do think it played a role in my adopting the transgender identity. I am not saying that I adopted this identity due to peer pressure, as the reason I adopted this identity also related to the deeply held feelings that I had. It is rather the intersection between my deep feelings ,and the group that led to my development of this identity. I think this is true of most identities, they are the intersection between biological factors, temprament, and social identity. Cross-gender feelings exists in all cultures but how they are expressed is different depending on cultures. In one culture one might be considered a shaman, in another an abomination, in another a transsexual. Cultures and subcultures say these feelings mean certain cultural identities and the ultimate expression lies at the intersection between the cultural ideas and the internal feelings.

In a way, there is something strange about talking about people “discovering their authentic identities”, because I actually see authenticity as something that opposes identity. I see it as something that lies beyond identities. Identities freeze things into place, and are almost like heuristics. They are shortcuts for who we are, that help explain who we are to others, but are always partial. So, affirming someones identities, is in a way taking them away from authenticity. It is not surprising that many of the people who write of detransition cite mindfulness as an important factor, because mindfulness is precisely a method for loosening identities and the holds they place on us.

I am not trying to say identities are all bad, indeed they are important. They are important because they allow us to feel a part of a group. They are important precisely because they act as heuristics. If we had to feel authentically into each moment of every day that would be a very slow, inefficient process, and probably quite difficult to pull off. Also there are problems associated with lack of stable identity, such as borderline personality disorder for example. Like Jack Engler said “you have to be someone before you can be no one”. Sometimes being authentic can be very difficult or impossible due to the pain associated with it, that can be a reason to live in identities. There is nothing wrong with that, it can be what is right for that time and it can serve an important protective function. Exploring identity is generally seen as part of normal adolescent development, because it relates to being in the world and playing roles in society. However, it seems like we have taken to reifying identities and mistaking them for the person themselves, when they can only be an approximation.

Can transition be the best solution? Yes, but I believe the answer lies under identity and not in identity, because that is where the creativity lies. So, I think it would be much better when looking at these issues to see someone as a person with gender dysphoria, rather than a trans person or a potential trans person. The same applies when exploring one’s own issues. This means the whole person doesn’t get lost and many solutions are possible. It also changes the question from “determining if someone ‘is’ transgender” to determining what the best way to move them towards wholeness.

A note for parents, friends, and loved ones of transgender

Several people have written to me who are the parents, friends or loved ones of someone who is considering transition, and are concerned about the idea and wondering what they can do. This is a complex issue. My own experience was that my parents did not take it well, particularly my mother. I have only seen her once in the last twenty years. Even though I eventually did resolve my issues in a different way and detransition, this was not helpful. Now we do get along better, part of it is time and part of it is my decision to detransition, but I still have some resentment towards her for not supporting me during that time, and it made it more difficult to detransition because I didn’t want her to be right. I do see that much of my own behavior at that time as selfish also. It can be a tricky question.

Still a few ideas:

Have compassion and love your child, and keep your door open to them. You do not have to approve of their actions, or pretend to, you have the right to your own integrity in that. However, it is important to continue to support them.

You can’t control the actions of your child, particularly if they are an adult child. They will do what they are going to do. If they are a teen, particularly a late teen they are soon to be adults and out of your control. You might be able to clamp down on what they are doing now, but in a couple of years they will be able to do what they want. Better that they explore their feelings while they still have your guidance, then do it when they don’t.

The issue of pre-pubescent children is a whole other issue. We know that historically most of these kids did not persist in their gender identity issues. (Around 84% in an older study) I worry a lot that transitioning these kids will increase the persistence rate. Also, I think the experience of puberty itself leads to the desistance as the biological instincts kick in, so preventing these children from experiencing at least some of this puberty might again make more of these kids transition than would otherwise.

This stuff is hard to deal with. I am critical of some of the ways the psychological community handles these issues and wish there were better alternatives to deal with it 20 years ago. I provide the ideas I have garnered through my experience and studies of psychology in the hope that others can be prevented from the suffering that I had. There are several people that have found them helpful, so I think I am on a good track, but I don’t think they will work for everyone. In particular these are deep-seeded issues that require more than blog posts to deal with. Some people will transition, and they deserve to have good lives. Much of the problems of transition have to do with social stigma associated with it.

Try to make sure they see a lot of different perspectives if you can. I do think there is a lot of groupthink happening currently, and I think it is important to counteract that. Do not trust any one authority on these matters, there are lots of crazy ideas going around, even in professional circles.

If you can meet them where they are, you should. If you don’t use their preferred name or pronouns it will just prevent you from communicating with them at all, and if you aren’t in their lives you don’t have any influence at all. Again this is a matter of your own integrity, but I think meet people where they are and giving them courtesy helps foster good communication.