The DSM-5 (the latest edition of the Diagnostic and Statistical Manual of Mental Disorders) used by the American Psychiatric Association and the American Psychologist Association uses the term "gender dysphoria". The former term was "gender identity disorder". — prothero

I don't think that's exclusively concerned with body issues, though, which is what Harry was discussing.

It's also worth pointing out that the APA clarifies that "gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition", and there's evidence that the distress is caused (or at least enhanced) by social stigma, rather than some inherent biological problem.

So the problem isn't with transgender people but with the twats who treat them poorly.

Since gender identification seems hard-wired, often from an early age, is it possible that the mismatch occurs in the womb (i.e. a female mind is paired with male genitalia, or vice versa)? This would of course necessitate gender identification being brain-based (or soul-based, if you believe in that) from the start, as opposed to being driven solely by physical features and hormones. If one could accept this concept, it is not a stretch to think that the genetic program could misfire once in a while, especially considering the idea that all embryos begin as female.

Secondly, not all transgender people are uncomfortable with their body. Plenty of transgender women have no desire to transition via surgery and hormones. They're more concerned with things like perceived gender roles, clothing, labelling, and other social aspects. — Michael

It would seem to me that if a person is comfortable with his or her body, doesn't want to change it, doesn't want to take estrogen or testosterone, doesn't want plastic surgeries performed, etc. then they are not not gender dysphoric, don't have a gender identity disorder, are not transgender, but are instead social justice warriors and politically fussy people specializing in gender terminology.

I understand what you mean when you say "they haven't changed their sex or gender", but isn't that really only relevant if we're going after a scientific understanding of human biology?

There's a huge perceived controversy over what the definition of gender is, and it all stems from a very simple and misunderstood issue that gets conflated with many others: ought we refer to transgenders with the gender they present as?

One side is confused into thinking that in order to refer to a MTF transsexual as a woman (or to convince people to do so) we need to alter our scientific understanding and definition of what gender is. A typical reaction to this is to then point to things like chromosomes and bone density in order to preserve our current scientific understanding. (sometimes they go further and say things like "suicide rates stay the same among pre and post-operation trannys, therefore they should not transition" or "would you indulge the delusions of someone who thought they were Napoleon Bonaparte or who wanted to cut their arm off?").

The way forward between sides is for the reactionaries (aside from the realizing that they're not doctors licensed to issue medical prognoses for gender dysphoria) to point out that they don't have an issue referring to people by the gender they present as (which would adequately assuage any/all bleeding heart liberal types). Jordan Peterson got famous not because he refused to use people's preferred pronouns, but because he refused to use people's made up pronouns (ze, xey, quay, etc...). The SJWs simply need to clarify their argument (it's about ethics, not biology): we can formally and informally refer to transgenders by their preferred gender without actually impacting our scientific understanding of sex/gender.

The truth here seems simple to me: people with gender dysphoria who transition aren't able to change their chromosomes, genetics, and many of the gender specific features which genes predefine, but genes do not necessarily predefine what gender someone desires to be (which is what gender dysphoria involves). "Catering" to transgenders by referring to them as the gender they're presenting as is a politeness, a courtesy, and a laudable effort not to emotionally injure someone who already has enough emotional hurtles before them. (Although, of course, at all times we reserve the right to just insult people).

Like professor Peterson I do also draw the line at made up pronouns (if someone cannot be happy with "they" then they can fuck off)...

There is one additional point of confusion that I think should be acknowledged:

For some reason (and you might be well aware of this) it's politically correct to hold the position that "gay people are born gay", and it seems to stem from some twisted and backward attempt to not hold gays inherently accountable for being gay (i.e: if it's genetic then we cannot balme them). While it's true that people can be born on a spectrum of hormonal predispositions, it is still necessary to be exposed to and learn about the objects of our sexual desire. Essentially what we become attracted to is learned rather than genetically programmed, but there is this myth out there that basically would suggest there is "gay gene". When it comes to gender dysphoria, a popular meme states "I am a male/female who was born in the wrong body" and similarly this could lead to the incorrect assumption that gender dysphoria is genetic and therefore it is the chromosomes themselves which are "disordered" rather than the rest of the genome. Our misguided fear that our environment might impact our sexual development in these ways has us shoving our head in the sand in this respect...

I think what you're referring to specifically is body dysmorphic disorder. However, this doesn't seem like the correct diagnosis. — Michael

No. What I was referring to specifically was a somatic delusion as that was the words I used and is plain to see to anyone paying attention.

https://en.wikipedia.org/wiki/Delusional_disorder

For one, those with body dysmorphic disorder tend to either imagine or exaggerate a perceived flaw. This isn't the same as, say, being a brunette but hating the colour and preferring to be blond. Of those transgender men who are uncomfortable with their body, it isn't that they're imagining that they have a penis or don't have a vagina, but that they recognise that they have a vagina but don't want one, and so it is more comparable to hating the colour of your hair (albeit there's likely to be more anxiety than in the case of hair colour). — Michael

What does it mean for them to recognize that they have the wrong genitalia? Do they mean that they were born in the wrong body, or that their mental state doesn't match their physical state? Which is it that is actually wrong - their mental state or their physical state?

No. What I was referring to specifically was a somatic delusion as that was the words I used and is plain to see to anyone paying attention. — Harry Hindu

Yes, and somatic delusions can be further distinguished:

• Conversion disorder: A somatic symptom disorder involving the actual loss of bodily function such as blindness, paralysis, and numbness due to excessive anxiety
• Somatization disorder
• Hypochondriasis
• Body dysmorphic disorder: wherein the afflicted individual is concerned with body image, and is manifested as excessive concern about and preoccupation with a perceived defect of their physical appearance.
• Pain disorder
• Undifferentiated somatic symptom disorder – only one unexplained symptom is required for at least 6 months.

What does it mean for them to recognize that they have the wrong genitalia? Do they mean that they were born in the wrong body, or that their mental state doesn't match their physical state? Which is it that is actually wrong - their mental state or their physical state?

I didn't say anything about them having the wrong genitalia. I said that they don't like what they have and would prefer something else, similar in kind (if not in degree) to not liking the colour of their hair, or the shape of their nose, or whatever.

And even though who do talk about having the wrong genitalia, it's not like they're claiming that they have some genetic abnormality, or that time has been re-written and what should have happened has been changed, or whatever nonsense you might think. It's just another way of expressing their discomfort with and dislike of what they have.

I didn't say anything about them having the wrong genitalia. I said that they don't like what they have and would prefer something else, similar in kind (if not in degree) to not liking the colour of their hair, or the shape of their nose, or whatever. — Michael

It's not the same to compare not liking your hair color to not liking your genitalia and wanting to remove it. It's more comparable to not liking the arm attached to your shoulder and want to cut it off. Unfortunately, society has made it okay to cut off genitalia because you don't like it, but good luck in finding a doctor to cut off your arm that you aren't comfortable with.

It's not the same to compare not liking your hair color to not liking your genitalia and wanting to remove it. It's more comparable to not liking the arm attached to your shoulder and want to cut it off. Unfortunately, society has made it okay to cut off genitalia because you don't like it, but good luck in finding a doctor to cut off your arm that you aren't comfortable with. — Harry Hindu

That comparison might be apt if one was talking just about removing one's genitals, and not of changing one's genitals. In the latter case it's more comparable to rhinoplasty.

But even if I were to accept the comparison, you have to look at why it is a problem to have one's arm removed, and whether or not this reason holds in the case of changing one's genitals. If it doesn't then it's a false analogy. I would say that removing one's arm is a problem if it would reduce the quality of your life (and, conversely, would be a good thing if it saves your life, as in the case of necessary amputations). Does this reasoning hold in the case of changing one's genitals? I don't think so. In fact, the reverse is true; those who successfully undergo the desired surgery have a better quality of life, given the improvements to their mental health.

All interesting observations.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Rant follows.

Ought we take the DSM-5 as gospel truth?

Since 1952, DSM-1 has been revised several times (a committee is probably working on DSM-6). Each time it gets bigger. Occasionally a malady is dropped, but mostly maladies are added and elaborated upon. Question: Is the DSM a work of science entirely, or is there an element of fiction in the book, fanciful embroidery around a small hard nub (or nut) of craziness? Certainly, therapists need to get paid and the DSM provides handy codes for insurance companies. The more codes, the more opportunities to get paid. (Oh, surely a profession as rock solid as mental health wouldn't make things up for mere pecuniary reasons, would they? Maybe there is a code in the DSM for highly educated and self-interested persons who imagine disorders in their customers that aren't really there?)

Not very long ago, (1970) homosexuality was a listed disorder. The psychoanalytic thinking at the time was that homosexuality was caused by overly close mothers and overly distant fathers, or some such thing. The diagnosis had a warm, moist, Freudian feel to it. My first attempts to understand myself involved Kinsey, on the one hand, and some psychoanalytic texts on the other. The psychoanalytic take on my disorder was not very flattering.

Well, then in 1972 or 1973 the APA up and changed it's mind. (There were lobbyists; they didn't do this in their sleep.) A spate of books was on offer at bookstores, like "The Healthy Homosexual" by George Weinberg. He coined the term "homophobia" in 1965. So, queers are fine now. One joke about gay marriage is: "Of course gays should marry. They have a right to be as unhappy as everybody else."

Once upon a time, transsexuals were extremely rare. A 1950s Danish comedian/pianist, Victor Borge, said in one skit that "In Denmark we have three sexes: male, female, and convertible". This was in response to Christine Jorgensen, a soldier from the Bronx, becoming the first publicly known transsexual in the US in 1952.

Then Miss Jorgensen, now Ms. Jorgensen.



The varieties of transsexualism have multiplied among the dividers (the "each of us is different" crowd). I'm more in the combiner crowd ("we're all much more alike than different"). I'm sure that there will be more categories of gender dysphoria in the future, because the APA committee is stacked with dividers. They especially like unique identifiers.

It could change at some point in the future. Just as homosexuality has had its reputational ups and downs, gender dysphoria might also. Oh no! Help! It might be scaled back!

Look at depression: the numbers of people diagnosed with depression is absurd (or tragic, I can't decide which). My sense of the world is that a lot of people are very unhappy because of their life circumstances, and if they could change their circumstances, they'd be a lot happier.

Antidepressants (prescribed by the train load) help people drag themselves through their drab, wretched lives, but they tend not to make people happy. That's because most of these people don't have a mental health condition which can be treated. It's because they have drab wretched lives which could be made better, but that means change, and change is difficult. Really difficult, sometimes. So, doctor, please write another Rx so I don't kill myself or somebody else.

Temporary end of rant. Exit here.

"As the darkly cloaked druidic figures encircled the arcane obsidian altar, the tallest among them stepped forward and opened the DSM that lay atop it's jagged surface..."

It actually bothers me how commonly people will just appeal to "it's in the DSM!" right before they compare transgenders to war-amps and "otherkin".

It's a somatic delusion they say, "you wouldn't indulge someone who wanted to chop their arm off would you?".

Where are they getting this from? I've heard the same things repeated so many times I'm convinced they all share the same source...

Indeed transsexuals have been around, and indeed they were a good deal more rarefied in the past (at least it seems this way) than they are today. Most transsexuals throughout history probably would have kept their heads down and went completely under the radar though, so it's really hard to even say how common gender dysphoria is outside of our current social norms. The stakes were much higher in the past of course; the possibility of being lynched would have prevented many would be cross-dressers and transsexuals from even attempting it. But, in modern times, we seem to be lauding the phenomenon to such a degree that I think a few too many folks are wandering or being ushered through this newly widened social orifice.

When adults make decisions about their future, even if those decisions come with significant risks, we don't always have ethical grounds to intervene (especially if there is reason to believe that as a treatment transitioning can improve their quality of life) but how might our ethical considerations change when it comes to children who desire to transition? Since many (perhaps most) children cannot grasp the full extent of what it means to transition, how can they possibly consent? (personally, I'm of the position that prior to puberty children should be allowed to express themselves, but the seriousness of prescribing hormone blockers must require some sort of robust medical assessment to accompany it, and I'm not so sure that our clinicians are up to snuff yet). Here's a fascinating documentary about the subject (I really love Louis Theroux's documentaries). Hormone blockers at very early ages and eventual hormone doses at the age of puberty can drastically increase the efficacy of a person's transition, but the younger the decision is made for a child to transition, the greater the risk that, as Louis puts it, "they get it wrong".

so, before and after.

I am going to watch it. Before I do, I'll express the opinion that young children should not be encouraged to pursue ideas whether they are actually boys or girls. And certainly not punished, either, for talking about it. Child guidance or child welfare workers should not, and parents should not do this either. As for adolescents taking steps to effect a transition from one gender identity to the other, no on that too, without overwhelming evidence that it will help. Rather than getting on the band wagon, parents and therapists would be better employed helping the child understand that maybe these feelings don't have to be acted upon (while they are in first grade, fCs.).

A physician or psychologist does not actually get paid for a diagnosis (DSM5 or ICD10 code).

ICD is the International Classification of Diseases, the current version is 10.

Instead one gets paid for the CPT code (current procedural terminology), what one does.

A bill to an insurance company pairs a ICD10 code with a CPT code. Does not matter if you are counseling a schizophrenic, a depressive or a gender dysphoria, the payment for a given amount of time spent in psychotherapy is the same. So there is little advantage to the provider of having tons of diagnosis codes to choose from. The proliferation of diagnosis codes has more to do with research, treatment evaluation and tracking the incidence of a given diagnosis in the population. True some CPT and ICD10 pairings will be rejected as the treatment does not fit the disease.

Mental health providers do not create diagnoses to lure new patients into their offices.
Generally speaking they are plenty busy without resorting to such tactics. In general most mental health patients are voluntarily seeking counseling or treatment (except for court ordered or other emergency interventions). It is society's approach to sexual behavior that generates plenty of stress, anxiety and depression that keeps mental health providers busy. Granted historically the mental health community regarded homosexuality as a condition in need of treatment or correction but I would say the mental health community is way ahead of society in general at this point and is leading rather than retarding progress.

In all classifications systems there are splitters and lumpers but the ICD10 and the DSM5 represent a group effort, a hierarchical structure and an effort to aid research and epidemiology.

The most common ICD10 codes submitted to insurance for payment
ICD 10 Codes For Depression
DSM 5 Code ICD-10 Description
309.0 F43.21 Adjustment Disorder, With depressed mood
ICD 10 Codes For Anxiety
DSM 5 Code ICD-10 Description
300.02 F41.1 Generalized Anxiety Disorder
ICD 10 Codes For Adjustment Disorder
DSM 5 Code ICD-10 Description
309.28 F43.23 Adjustment Disorder, With mixed anxiety and depressed mood
ICD 10 Codes For Post Traumatic Stress Disorder (PTSD)
DSM 5 Code ICD-10 Description
309.81 F43.10 Post Traumatic Stress Disorder

CPT Code Footnote(s) Description
90791 1 Psychiatric diagnostic evaluation
90792 1,3 Psychiatric diagnostic evaluation with medical services
90832 2 Psychotherapy, 30 minutes with patient and/or family member
90833 2,3 Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service
90834 4 Psychotherapy, 45 minutes with patient and/or family member
90836 3,4 Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service
90837 6 Psychotherapy, 60 minutes with patient and/or family member
90838 3,6 Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service
90839 6 Psychotherapy for crisis; first 60 minutes
90840 2 each additional 30 minutes
90846 4 Family psychotherapy (without the patient present)
90847 4 Family psychotherapy (conjoint psychotherapy) (with patient present)
90849 4 Multiple-family group psychotherapy
90853 4 Group psychotherapy (other than of a multiple-family group)

ICD10 codes having to do with sexual behaviors

F64 Gender identity disorders
F64.0 Transsexualism
F64.1 Dual role transvestism
F64.2 Gender identity disorder of childhood
F64.8 Other gender identity disorders
F64.9 Gender identity disorder, unspecified

• Deviation (in)
sexual F65.9
fetishism, fetishistic F65.0
• Fetishism F65.0
sexual F65.9
bestiality F65.89
erotomania F52.8
exhibitionism F65.2
fetishism, fetishistic F65.0
transvestism F65.1
frotteurism F65.81
masochism F65.51
multiple F65.89
necrophilia F65.89
nymphomania F52.8
pederosis F65.4
pedophilia F65.4
sadism, sadomasochism F65.52
satyriasis F52.8
specified type NEC F65.89
transvestism F64.1
voyeurism F65.3

Psychological and behavioural disorders associated with sexual development and orientation
Note: Sexual orientation by itself is not to be regarded as a disorder.
F66.0 Sexual maturation disorder
The patient suffers from uncertainty about his or her gender identity or sexual orientation, which causes anxiety or depression. Most commonly this occurs in adolescents who are not certain whether they are homosexual, heterosexual or bisexual in orientation, or in individuals who, after a period of apparently stable sexual orientation (often within a longstanding relationship), find that their sexual orientation is changing.
F66.1 Egodystonic sexual orientation
The gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it.
F66.2 Sexual relationship disorder
The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner.
F66.8 Other psychosexual development disorders
F66.9 Psychosexual development disorder, unspecified

One side is confused into thinking that in order to refer to a MTF transsexual as a woman (or to convince people to do so) we need to alter our scientific understanding and definition of what gender is. A typical reaction to this is to then point to things like chromosomes and bone density in order to preserve our current scientific understanding. (sometimes they go further and say things like "suicide rates stay the same among pre and post-operation trannys, therefore they should not transition" or "would you indulge the delusions of someone who thought they were Napoleon Bonaparte or who wanted to cut their arm off?").

The way forward between sides is for the reactionaries (aside from the realizing that they're not doctors licensed to issue medical prognoses for gender dysphoria) to point out that they don't have an issue referring to people by the gender they present as (which would adequately assuage any/all bleeding heart liberal types). Jordan Peterson got famous not because he refused to use people's preferred pronouns, but because he refused to use people's made up pronouns (ze, xey, quay, etc...). The SJWs simply need to clarify their argument (it's about ethics, not biology): we can formally and informally refer to transgenders by their preferred gender without actually impacting our scientific understanding of sex/gender. — VagabondSpectre

Fear that scientific understanding will be destroyed is founded in doing science backwards, as if we were describing or understand bodies by finding a sex category ( "male" and "female" ), which then allowed us to see the presence of various physical features like chromosomes or bone density.

Science doesn't work like this. In the observation or description of the body, we begin with the body, not some extra logical/identity order ("male", "female" ) which then determines when certain bodily features occur. The supposed disaster is absurd because in the unmooring of "male" and "female," it was never descriptions of the body at stake, only the identity and ethics of categorising bodies we do observe.

The "SJWs" already know the scientific (by this I mean accurate description of bodies) understanding isn't at stake or threatened. Their point is what most people consider the "scientific understanding" is not actually a scientific account of bodies, but rather categorisation and ethic for sorting bodies which might be observed (and one which denies, rejects and discriminates against trans identity).

People like Peterson aren't defending a scientific understanding of bodies. They are protecting an identity and ethic of essentially sorting bodies (which may or may not be described) in categories of "male" and "female," which then masquerades as "scientific understanding."

"SJWs" have been clarifying their argument is about ethics and identity for decades . People like Peterson just don't see it because they equate their essentialist ethic and identity with understanding of bodies.

It's simply not true. Just because someone is sorted into the "female" category, it doesn't prevent us from describing they have a penis, an absence of breasts, certain chromosomes or a particular bone density. We can even make such descriptions without using a gender of sex category at all.

↪Bitter Crank A physician or psychologist does not actually get paid for a diagnosis (DSM5 or ICD10 code).

ICD is the International Classification of Diseases, the current version is 10. — prothero

Ah ha! So, I was wrong about that. ¥@#&!¢Ω Thank you for popping my error bubble. So, if it isn't used for payment, then what good is the DSM?

so, before and after. — Bitter Crank

Now after.

Quite interesting, but qualms...

Little pre-school or kindergartener Camille (birth name Sebastian) is totally convinced she is a girl. She wears little girls clothing. Camille didn't drive to Target by herself and pick up her outfits. Someone aided and abetted the child's wardrobe selection. There was a lot of talk between interviewer and parent, therapists and parents, with Sebastian present. Was the child's self-narrative her own, or was she constructing her self-narrative from fragments of conversation with her parents?

No one asked her this, but I wonder what Sebastian's/Camille's parents wanted before they knew the sex of their child.

Sebastian's/Camille's future seems on track to be treated as soon as possible.

It's worth noting that puberty blockers, estrogen, and testosterone have some known side effects in adults (not all of them desirable) and there has been very little research into the effect of administering hormones to adolescents that affect bone density, brain development for the last 10 years of neural completion age 15 to 25), or health in general. These drugs haven't previously been prescribed to adolescents (say 10 years ago) so the prescribers don't know what effect they might have.

The therapists think that they can identify children as early as 18 to 24 months age who think they are "the wrong sex in the body". Do they need their heads examined?

Dr. Rosenthal is an endocrinologist (appropriately in many ways) but not a psychotherapist. His psychotherapeutic side-kick, (name?) was asked about risks of encouraging, or assisting these young people to make the transition. Her response: “the one risk we have is holding them back.” I'm not so sure about that.

Here is a PBS FRONTLINE take on young transsexuality.

That comparison might be apt if one was talking just about removing one's genitals, and not of changing one's genitals. In the latter case it's more comparable to rhinoplasty. — Michael

"Removing" falls under the category of "changing". The man that is uncomfortable with his arm can replace it with an artificial one.

But even if I were to accept the comparison, you have to look at why it is a problem to have one's arm removed, and whether or not this reason holds in the case of changing one's genitals. If it doesn't then it's a false analogy. I would say that removing one's arm is a problem if it would reduce the quality of your life (and, conversely, would be a good thing if it saves your life, as in the case of necessary amputations). Does this reasoning hold in the case of changing one's genitals? I don't think so. In fact, the reverse is true; those who successfully undergo the desired surgery have a better quality of life, given the improvements to their mental health. — Michael

...and this is why I asked earlier in the thread, "what do they mean when they say that they are uncomfortable with their genitalia?" You ignored the question which made me believe that you thought it was relevant. Now you seem to be saying it isn't.

Do they think that they are in the wrong body, or what? To say that you are uncomfortable with your genitalia as opposed to your arm indicates that you are uncomfortable with your gender/sex - which is a defining quality of who we are as a person and influences how we think (women and men have different amounts of various hormones as well as different sex organs). All humans have arms, but not every human has the same genitalia. Our genitalia is one of those things that distinguishes us from other humans and can drastically influence how we behave and think. So to say that one is uncomfortable with their genitalia is to say that they are uncomfortable with themselves as a whole and that they apparently wish to be someone else, not a different version of themselves, because if they were born with different genitalia, odds are that they would still have the same problem, because the problem isn't in their genitalia, it is in their brain.

Look at depression: the numbers of people diagnosed with depression is absurd (or tragic, I can't decide which). My sense of the world is that a lot of people are very unhappy because of their life circumstances, and if they could change their circumstances, they'd be a lot happier.

Antidepressants (prescribed by the train load) help people drag themselves through their drab, wretched lives, but they tend not to make people happy. That's because most of these people don't have a mental health condition which can be treated. It's because they have drab wretched lives which could be made better, but that means change, and change is difficult. Really difficult, sometimes. So, doctor, please write another Rx so I don't kill myself or somebody else. — Bitter Crank

Yes, the drug manufacturers are enjoying a golden age as doctors over diagnose depression, AD, etc. Anti-depressants are one way of dealing with life's problems, but so is creating delusions. People with delusions have them as a means of looking over life's bad parts. Delusions make the delusional feel better about life and allow them to continue on living. Religion is basically a mass delusion - one held by many as a means of dealing with the fear of death and the unfairness in the world. It is reinforced by the many who also hold the same delusion, and even popularized.

There are those that even have the issue of not getting enough attention. They didn't receive the necessary amount of attention as a developing child, or maybe received to much, and now, as adults, they crave it and will do virtually anything to get it. Some will even do unconventional or immoral things just to get attention. The attention transexuals receive is enticing to those with this problem. Some will do anything for attention. This may even explain the degrees of transexualism - where some actually go through and change their genitalia, while some simply cross-dress. Some are more gung-ho about their delusion, while some aren't willing to go all the way with their belief, as some are merely doing it for the attention it brings while some actually believe themselves to be the opposite sex than what they were born as.

In fact, the reverse is true; those who successfully undergo the desired surgery have a better quality of life, given the improvements to their mental health. — Michael

This supports the idea that it is a delusion. The delusional get easily offended if you question the truth of their belief (both the religious and transsexuals share this trait) and if you act in a way that supports their delusion (such as agreeing with them and performing a sex change on them) then they believe that this supports their delusional belief. This is why the religious congregate together - to be with others that share the same delusion - which reinforces their belief in the truth of the delusion. When doctors share your delusion and the rest of society shares it, then that makes everything better.

Don't we want (like the Gates Foundation) everyone to lead a happy, healthy and productive life. So shouldn't we defer to the individuals gender identity and preferred gender role? Biology (psychical gender) is one thing and social roles are quite another.

Quite interesting, but qualms...

Little pre-school or kindergartener Camille (birth name Sebastian) is totally convinced she is a girl. She wears little girls clothing. Camille didn't drive to Target by herself and pick up her outfits. Someone aided and abetted the child's wardrobe selection. There was a lot of talk between interviewer and parent, therapists and parents, with Sebastian present. Was the child's self-narrative her own, or was she constructing her self-narrative from fragments of conversation with her parents?

No one asked her this, but I wonder what Sebastian's/Camille's parents wanted before they knew the sex of their child.

Sebastian's/Camille's future seems on track to be treated as soon as possible. — Bitter Crank

There's a tricky political minefield surrounding this subject (this doc was released in 2015 when the conflict was less pronounced) but I do tend to agree with your sentiment here. When the parents and the (well paid?) clinician were openly stating the facts about who Camille really is with her sitting right beside them I was somewhat disturbed by their inability to consider the impressionability and intelligence of their child. Kids might look like they are playing obliviously but if you mention their name they will certainly listen, and they aren't stupid enough for it all to go above their heads.

In the progressive rush to help children transition, we might be ironically limiting their freedom to choose by boxing them into a particular gender identity with constant reassurance, clothes, toys, etc...

It's worth noting that puberty blockers, estrogen, and testosterone have some known side effects in adults (not all of them desirable) and there has been very little research into the effect of administering hormones to adolescents that affect bone density, brain development for the last 10 years of neural completion age 15 to 25), or health in general. These drugs haven't previously been prescribed to adolescents (say 10 years ago) so the prescribers don't know what effect they might have. — Bitter Crank

The risk of unalterable change is what concerns me most in all this, especially since the desire to be socially progressive is perhaps leading to reckless over prescription...

The therapists think that they can identify children as early as 18 to 24 months age who think they are "the wrong sex in the body". Do they need their heads examined? — Bitter Crank

They're reaching so far beyond the cutting edge of behavioral and neurological scientific theory that it's astounding.

Dr. Rosenthal is an endocrinologist (appropriately in many ways) but not a psychotherapist. His psychotherapeutic side-kick, (name?) was asked about risks of encouraging, or assisting these young people to make the transition. Her response: “the one risk we have is holding them back.” I'm not so sure about that. — Bitter Crank

A meme circulating the debates on this subject is "the suicide rates stay the same" (although most people who post it don't know which suicide rates are being compared). What it actually refers to is the fact that bottom surgery (surgical alteration of the genitals) does not lead to a statistically significant reduction in suicide rates among transgender individuals. Whether or not transitioning on the whole leads to a reduction in suicide is utterly not known, as gathering statistics on people with gender dysphoria who choose not to seek treatment or act on it is far too difficult. What information we do gain in this statistic is clouded by the host of spurious factors that could cause suicide which are shared by all transgenders regardless of whether or not bottom surgery has occurred (it could be that what causes them to have high suicide rates doesn't have to do with the current state of their genitals, but instead their experience in society).

What the endocrinologist's sidekick certainly doesn't know is how much harm they might be causing by offering an authoritative prognosis of hormone blockers to a child who may come to change their mind. The younger the child is the less they comprehend about the long term ramifications of their decision (and about everything really), so they have less capacity to decide and consent for themselves.

I suspect that if you start treating a 1-2 year old as the opposite of their gender (regardless of which child) then there's a good chance they will conform to the identity thrust upon them...

Even very young children have sexual interests, whatever adult sexual course they will follow. I vaguely remember having sexual thoughts (feelings? don't know) when I was maybe 4 or 5. (No, this is not a child abuse story.) I was always interested in other boys. I then had no terminology for any of this, of course.

Question: Would it have helped me develop if my parents had been like the intrusive-manager parents in the documentary? (It would have helped me, certainly, if my mother had been less hysterical about childhood sex play. It would have helped her a great deal if she had been able to deal with sexuality and fertility before we were all born.)

Answer: Almost certainly not. The medical/psychological understanding of those decades, and the probable interventions which were likely were not to be wished for. But I don't want to knock my parents too much. They both did as well as they could with limited resources and a large family, and it was not bad.

Most people probably do not have "ideal" childhoods managed by "perfect parents". They muddle through and none-the-less manage to put respectable adult lives together when the time comes. (Of course, we all know people who decidedly don't manage.) The transsexuals I have known were also putting adult lives together, and their gender identity was one among several issues they had to cope with.

Anyone read the Wasp Factory? Gender politics meets Lord of the Flies. With hilarious results, not.

Anyone read the Wasp Factory? Gender politics meets Lord of the Flies. With hilarious results, not. — unenlightened

Yes. I remember it as deeply creepy :)