If someone says they are gay or transgender we have to have a really good reason to frame them as suffering from some form of mental disorder > which is a separate item to transgenderism or sexual orientation as far as we currently understand these phenomena. — I like sushi

I want to be clear that the desire to be the other sex is not a disorder. Being trans gender is not a disorder. It is when that desire starts disrupting your life to the point you cannot function normally that you have gender dysphoria. Yes, some people talk about it like teenagers talk about 'my OCD' in a slang way, but diagnosed gender dysphoria sucks.

It is not the desire to be another sex that is the disorder, it is when it consumes your life. Just like you can be depressed at times and not need medication, you can have gender dysphoric moments and manage it fine in your life. Transition is not a way of life. It is a medically prescribed coping mechanism for chronic gender dysphoria that does not respond to any other methods or medication. In my experience, these are usually not trans gender individuals, these are trans sexuals that desire the body and recognition of being the other sex. That is why it is covered by insurance. It is not a normal or natural thing for anyone to do. It is a treatment for an inability to regulate oneself normally anymore.

Are there people who want to make it a life style? Yes. I don't mind personally as long as they don't make insurance pay for it. Insurance is for treatment, not cosmetic alteration of the body for one's own pleasure. I would argue that if you have a desire to alter your body its a disorder of a different kind, but not gender dysphoria.

Maybe many people here do not appreciate that this century people will very likely be able to literally switch their bodies from male to female. — I like sushi

Could be. Stem cell research could come along finally and we could eventually change someone's sex. In science a species is considered to have changed their sex if they can serve the reproductive role of the other. So a male would shift to producing eggs which can be fertilized and hatched. A female would produce sperm to fertilize other eggs. But again, this is really trans sexuals we are talking about. Plenty of trans gender individuals have no desire to change their body. Nice contribution!

The main point Banno seems to be making here is there is a clear difference between stating something is logically true and making a judgement call. Ironically he agrees with Jordan Peterson here, — I like sushi

:wink:

The difference between a fact and a value has a longer history than eve that, and Peterson, for all his faults, may have some idea of what Hume had to say.

If someone says they are gay or transgender we have to have a really good reason to frame them as suffering from some form of mental disorder > which is a separate item to transgenderism or sexual orientation as far as we currently understand these phenomena. — I like sushi

I'm not sure if this was a view you were attributing to someone else, or were advocating yourself.

Might be worth clarifying.

For my part, I see Amadeus as hiding his prejudices in medical language. — Banno

Schizophrenic people are also mentally ill. There is no prejudice in admitting to this. I cannot even begin to understand why you run to this instead of looking the statement in its face: If you have a direct break with reality that causes severe distress, that's a mental illness. It need not be intractable, or alienating, or anything worthy of anything but compassion and understanding. They are not exclusive to one another. I have nothing to hide. I could simply be wrong.

Its now a mental health condition like depression. — Philosophim

I'm happy to use this language, if its easier on the mind. I don't particularly see a difference between the two, personally. Although, I am fairly convinced depression is an amorphous diagnosis not pointing to any particularly brainstate.

"Transgender" is an umbrella term for people whose gender identity differs from the sex assigned at birth, while gender dysphoria is the distress or unease caused by that difference. — Banno

This, as best I can tell, is pure prevarication. Transgenderism is a behaviour designed to ameliorate the symptoms of a mental condition of dysphoria as we call it. If you want to tease those two apart, fine, let's do that. I'm happy as long as the language accurate represents what I'm saying. The point is that having a mental state which sets reality (your sex) apart from yourself (your identity) then there is something aberrant going on - as with people who believe they're Jesus - just different in kind.

So with that said:

Do you have an argument to support that assertion? — Janus

They have a direct break with the reality of their actual, objective body. If you have to quibble with the language to make this work, so be it. But semantics clearly aren't hte big issue here.

I don't see that I owe a reply to Amadeus, given his blatant hostility. — Banno

I've been overtly polite to you recently. If you've read my posts as 'blatant hostility' I think perhaps you need to take a long, calming break from talking to other humans lest your victim complex cause you to but heads with everyone. I'll continue to be polite.

I'm here. If you have substantive points to make, or if there is something I have not addressed, set it out. — Banno

You literally do not read posts with substantive points, and then call htem 'meandering'. It's impossible to get on with you in this mood.

Amadeus is like a magic eight ball. When he gets shook up he will just say shit. — I like sushi

You might say that. I couldn't possibly comment... — Banno

Am I'm the hostile one... right oh. Theres something woefully amiss in a couple of blokes talking to each other about someone else in terms that are objectively nonsense. Far be it from me i guess.. You cannot continually be a dick and pretend its someone else's fault. Perhaps you've not had children, but none of this behaviour is foreign to those who have.

Looks pretty clear. Most trans people have a mental illness.

You might consider what it is you are defending. — Banno

Reality. Mental illness exists. Believing you're in the wrong body is mental illness writ large. Defending that belief without recourse to the aberrant, irrational nature of it is beneath the type of discussion we're having.

It may be worth you not replying at this point. I can see there is no actual discussion possible here. There's a severe inability to divorce your feelings from what's said, and what's said from who has said it. I can't quite bring myself to get into that pool.

They have a direct break with the reality of their actual, objective body. If you have to quibble with the language to make this work, so be it. But semantics clearly aren't hte big issue here. — AmadeusD

The assumption that all transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization.

The assumption that all transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization. — Janus

I believe he's talking about transitioned individuals. The only way to be medically transitioned is to be diagnosed with gender dysphoria. There are people who transition who do it for cosmetic reasons, but from the context of his post he's not referring to them. So unless a transitioned person faked gender dysphoria or paid for it on their own dime, its a safe bet that they have gender dysphoria.

Well he said this,

The majority of trans people are not victims of anything but the unfortunate situation of having a mental illness. — AmadeusD

and my response was misworded and should have been referring to the "majority" rather than "all'. So, it should have read: " the assumption that the majority of transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization.

and my response was misworded and should have been referring to the "majority" rather than "all'. So, it should have read: " the assumption that the majority of transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization. — Janus

Not a worry at all. If you mean trans gender people, I agree. But if his intention was transitioned people, he's correct. The number of medically transitioned individuals far outweighs those who did it cosmetically.

The presumption, in , seems to be that transitioning does not treat gender dysphoria.

That is, from what I have seen, factually incorrect. Meta-studies are readily available to justify this position.

Note that we have moved to empirical studies, rather then considering conceptual issues. We are no longer doing philosophy.

Right, if we say that gender dysphoria is a mental illness, and we have a cure (transitioning) then problem solved. For the rest of the transgender folk who don't experience intense pain and suffering, but perhaps just some milder confusion and suffering attendant upon feeling "different" on account of their desire to identify as the gender opposite to their biological sex, there should be no major problem if they receive the counseling they may or may not need.

If I recall correctly, @Philosophim had strong reservations concerning regret after gender-affirmation surgery. Studies I found show that regret is a factor, however at low levels, but note methodological issues. It doesn't appear to be a strong enough factor to inform policy.

People may regret many different kinds of decisions in life which cannot, for practical reasons, be undone. That fact does not justify intervention by the state to "protect" people from themselves, unless perhaps if regret were found to be intense in the majority of cases.

Yep.

The presumption seems to be that transitioning does not treat gender dysmorphia. — Banno

Banno both Amadeus and I noted that transition was a treatment for gender dysphoria.

Right, if we say that gender dysphoria is a mental illness, and we have a cure (transitioning) then problem solved. — Janus

To my understanding it is not a cure. It is a treatment that lessens the impact of it, but gender dysphoria still persists in many transitioned individuals. Its like people who are chronically depressed. Depression medication doesn't necessarily cure depression, but it does lessen its symptoms and helps one cope to live life more normally. Take a person off of it, and they'll go right back to being depressed.

For the rest of the transgender folk who don't experience intense pain and suffering, but perhaps just some milder confusion and suffering attendant upon feeling "different" on account of their desire to identify as the gender opposite to their biological sex, there should seem to be no problem if they receive the counseling they may or may not need. — Janus

Correct. The ultimate goal is to regulate your desires and dissapointments in life like a normal person. You don't want to binge on alcohol and become a perpetual drunk that becomes homeless. You also don't want to wallow in agony because you're ugly and you'll never find anyone that loves you. Generally people learn to regulate these wants and needs or use healthy coping mechanisms to regulate them.

Therapy is approached first to see if the person can learn how to manage on their own. A depressed person might be told to fix their diet, start exercising, and go outside. An addict might be given a sponsor to help them out of their unhealthy desires. Sometimes though a person's brain chemistry is too off kilter and cannot be fixed by the individual or with common methods. As such, you escalate to medince. While all medicine is innately of some health risk and impact to the body, its worth it if it fixes the larger problem in their life which is causing them much more harm.

Transition is an obvious harm to the body and mind. In males the initial medicine eventually leads to chemical castration. If estrogen is introduced in more serious cases, there is increased risk of osteoperosis and deep vein thrombosis. Brain scans reveal that transitioned people on medication have parts of their brain altered over time. But it can lead to a person who was completely unresponsive or self-destructive in life to turn themselves around. If a person goes from being an absolute mess of a human being that can't take care of themselves or is one drug abuse away from an overdose, its an overall benefit.

If I recall correctly, Philosophim had strong reservations concerning regret after gender-affirmation surgery. — Banno

I'm not sure if I mentioned that here, but maybe in another thread. Its not that regret should be a factor in transition, its that it should be irrelevant compared to health outcomes for any treatment. The point of treatment is to make the patient is objectively, not subjectively better. If a person has improved physical and mental health markers, as well as living a better and healthier life than prior, their regret is irrelevant. Plenty of people didn't regret getting opioids during the opioid crisis, despite the fact many were becoming addicts with all the shriveling of mind, morals and lifespan that comes with it. You also might get a nice boost for something for five years, then later suffer poor health due to the treatment. Those five years may have given you such a high that you don't regret it, but its still an objectively long term poor health outcome.

That fact does not justify intervention by the state to "protect" people from themselves, unless perhaps if regret were found to be intense in the majority of cases. — Janus

Agreed. No one of any authority has any business enforcing subjective opinions or outcomes. It should always be objective outcomes that should be considered. Regret is purely subjective.

The assumption that all transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization. — Janus

This could be a problem of words, again: I have never heard of a single 'trans gender' person who doesn't experience dysphoria. In fact, that is the basic fundamental boilerplate on which it rests. Else, there is literally no reason to do anything but go on about your life. Is the contention that there are people claiming to be 'transgender' who have no emotional or psychological problem with their body or 'gender' (taking this to be an internal feeling... obviously, I don't buy that, but onward..).

I believe he's talking about transitioned individuals — Philosophim

Hmm. Definitely people who have, are or plan to transition yes. In Janus' take there's an equation like this "0+1=2" which I don't understand. We don't go through processes like this, particularly if we believe we're bound to experience social pressure and 'bigotry', unless its ameliorating a worse situation, no? I've been pretty uncomfortable with my gender (as a general comment) since childhood. Not once have I ever even remotely entertaining the idea of mutilating or otherwise permanently changing my body on account of that. I have some relatively severe dysphoria over a couple of specific aspects of my body. Still hasn't occurred to me. So, if we're not going to go the 'mental illness' route (understanding this is not a pejorative) what's giving us the other '1'? Personal choice? In that case, I don't care. There shouldn't be any policies regarding this and people should put up with existing policies. I take it this is untenable to most sides of hte question, so I reject it.

Regret doesn't seem to be a huge factor yet. The advent of surgeries and puberty blockers for minors around this issue has more than likely thrown a spanner in that work - and we are likely to see a trickle, growing to a flood, of regret in that demographic. It's started, but in very small numbers so regret shouldn't be used as a policy-driver. Agreed.

the assumption that the majority of transgender people experience gender dysphoria, i.e. profound unhappiness and psychic distress, is an unfounded generalization. — Janus

False.

See here, here and here. The biggest problem with this question (and we may simply have to set it aside) is that clear indicators of dysphoria (depression, anxiety, self-hatred, body image issues, insecurity around social standing etc..) are post-hoc put in the category of "social consequence". This seems contrary to how we deal with most psychological states. In particular, states that are clearly and unambiguously abnormal. There is a clear, and unambiguous difference between non-trans individuals and trans individuals in terms of, lets call them co-morbidities. The directionality of these, imo, has been intentionally skewed. This is why it may need to be set aside. There is no way to decide that point, unless the future turns out as I expect (or not, obviously). But hte prevalence of symptoms in people who identify as trans says to me, and many others, that there's a direct link between the two. A basic sense check seems to support this: If you thought you were in the wrong body, it would be distressing.

If trans gender individuals (or some number) don't feel they're in the wrong body, what are they transitioning between? Gender isn't something that requires surgery and HRT unless conflated with sex. And if conflated with sex, we have a direct break with reality causing distress. I have a feeling a few balls are being hidden here.

Right, if we say that gender dysphoria is a mental illness, and we have a cure (transitioning) then problem solved. — Janus

Roughly speaking, I agree with this. The problem for me is that the public behaviour of many transitioned individuals still reads like someone experiencing mild psychosis. This is not a fair thing to say, because the overall nature of the condition is such that you will be set apart from most people around you - which is awkward, and leads to some silly behaviours. But I am also a 'if you're male don't go into the female loos' thinker so there's that issue too.

As Banno notes, we're skewing the line between conceptual analysis and empirical data. I just think the data is shit. I think that's reasonable too. Its mostly fresh, relies on self-report and for the most part is unreplicated and hasn't been followed up. I'm willing to take it on it's face with caveats only. We are also looking at an area of medicine which is almost wholly populated by activists. That's an issue.

I didn't see figures in those links identifying the percentage of trasngender people who experience gender dysphoria. I skimmed them, so may have missed that information, if it was there.

Anyway, I asked Claude:

Hi Claude, I wonder if you would be able tell me if there are studies which have detremined statsitics concerning how many transgender people suffer from gender dysphoria

I'd be happy to help you find information on this topic. Let me search for recent studies and statistics on the prevalence of gender dysphoria among transgender people.

Based on the research, there's an important distinction to understand: not all transgender people necessarily experience gender dysphoria, and the statistics vary significantly depending on how these terms are defined.

Here's what the studies show:

Gender Dysphoria Diagnosis vs. Transgender Identity:

Gender dysphoria (GD) as a clinical diagnosis according to the DSM-5 is relatively uncommon, with prevalence estimates ranging from 0.005% to 0.014% for people assigned male at birth and 0.002% to 0.003% for people assigned female at birth.

. However, the DSM-5 acknowledges these figures are likely underestimates since they're based on clinic referrals.

In contrast, studies find that about 0.8% of U.S. adults (over 2.1 million people) identify as transgender, and 3.3% of youth aged 13-17 (about 724,000 young people) identify as transgender
Williams Institute
.

The Key Difference:

Gender dysphoria specifically requires clinically significant distress related to gender incongruence. There is a higher prevalence of people who self-report as transgender than there are patients being treated for gender dysphoria
PubMed Central
. This means many transgender individuals may not experience the level of distress that meets diagnostic criteria for gender dysphoria, or their distress may resolve with social transition and support.

So to directly answer your question: studies show that while a significant number of transgender people do experience gender dysphoria (enough to seek clinical treatment), the actual percentage who experience dysphoria varies and is difficult to pinpoint precisely. The relationship isn't one-to-one—being transgender doesn't automatically mean someone has gender dysphoria as a clinical condition."

It appears, if Claude is correct, that there may be people who experience gender dysphoria but have not being clinically diagnosed as such. The other problem is that the term 'gender dsyphoria' itself is not a precise one and feelings of dysphoria could be on a spectrum form very mild to very intense. I would only class it as a mental illness if it causes sufficient distress to make life extremely unpleasant and/ or render people socially dysfunctional. So, we can only guess.

I do know one person (a fifteen year old female who is the daughter of a good friend) who identifies as a man, and shows no signs of being very distressed about it at all. That said, I don't live with her. Her father does not seem much concerned when I have talked about it with him.

I tried the same game.

This doesn't tell us anything about the question we're asking unfortunately - I had to just dig. It's simply telling us small numbers of people are in each group. We already knew that. The papers I've cited give some fairly good reason to connect symptoms with the diagnosis (as if that's not clear anyway?). If that is reasonable then there's a good reason to think that the transition is post-symptoms. Again, I can't see that this owuld be controversial except for the bullets it might present ot the activist class.

The other problem is that the term 'gender dsyphoria' itself is not a precise one and feelings of dysphoria could be on a spectrum form very mild to very intense. I would only class it as a mental illness if it causes sufficient distress to make life extremely unpleasant and/ or render people socially dysfunctional. So, we can only guess. — Janus

Yes, that's all quite fair. No issues.

I do know one person (a fifteen year old female who is the daughter of a good friend) who identifies as a man, and shows no signs of being very distressed about it at all. That said, I don't live with her. Her father does not seem much concerned when I have talked about it with him. — Janus

I know several who appear that way. The ones I know well enough make it quite clear to me that this is a mask.

I think we've reached a measure of agreement.

I know several who appear that way. The ones I know well enough make it quite clear to me that this is a mask. — AmadeusD

That is of course quite possible. None of us are perfectly psychologically healthy though (whatever that might mean) so I cannot think of any more apt measure of illness than the inability to function adequately, or even at all.

I wonder what principally causes the suffering associated with gender dysphoria and the transgender state generally, if it is not entrenched social attitudes around gender, which make transgender people feel as though they don't fit in. Some might not suffer much or even at all because they simply just don't give a shit what others think. We are all different.

For sure - there's also the different interpretations of when that level of disorder kicks in.