Groucho Marx used to tell of a man who went to see a psychiatrist:
So you see, doctor, the problem is that my brother thinks he’s a chicken.
Well, have you told him he’s not a chicken?
No.
Why not?
Because we need the eggs!
As the implosion of Western Civilization accelerates, the once unthinkable becomes part of mainstream medicine. In truth a book could be written on the mainstreaming of human perversion, and if such a book were to be written one its darkest chapters would be the transgendering of children with gender dysphoria. From the Daily Mail comes the story of an eleven-year old boy, adopted son of lesbian parents, who began transitioning hormonally to a “female” at age eight. Read the stomach-churning story here.
There are several dimensions of the story that are noteworthy, and while the lesbian angle could be further explored, there are doubtless many lesbian couples who would never countenance what this couple has done. That’s worth stressing at the outset, as the real villains in all of this are the psychologists and physicians at four hospitals in the U.S. who perform this mutilation of children. From the story:
San Francisco, right by Berkeley, is one of four cities in the United States with a hospital that has a program for transgender children. The University of California San Francisco is home to the Center of Excellence for Transgender Health. Children are seen at length by mental health professionals and then treated by pediatric endocrinologists. Others cities with youth programs are Boston, Seattle and Los Angeles.
Four hospitals that have specialty centers for mutilating children!
If that sounds surprising, it really shouldn’t be. It is the natural result of abandoning the idea that there is such a thing as natural moral law, objective truth, and clear limits to human behavior. It is the result of the American academy being filled to overflowing with radical professors who profess such nonsense in order to sell their perversions as serious scholarly work.
It is the result of so much more that anything less than a book would be to trivialize a very complex phenomenon, and yet it all boils down to something very simple:
Our doctors, the ones who spent four years in college, four years in medical school, four years of internship and residency training, two years of post-doctoral fellowship training, fourteen years of adulthood in training in all, are the ones who have caved. They look upon seriously deluded human beings and make comfortable livings playing along with their delusional pathology. The mental health professionals who have neither the time nor the inclination to engage the long-term work of healing the individuals who believe they are “really” the opposite gender locked in the wrong body sign off on a process that then leads to chemical mutilation at the hands of endocrinologists and surgical mutilation after that. The results are ghastly.
Reports indicate a suicide rate for transgendered individuals that stands at a staggering 41%. Many in the LGBT community attribute those numbers to discrimination and harassment in society. Another brother who needs the eggs.
What is considered harassment? Heterosexuals who don’t want transgendered individuals sharing rest rooms with them? Are women to blame when they don’t want a mutilated and deluded male in a dress sharing their rest rooms? Must all of society be forced to play along? Consider that in the city of San Francisco, such surgery is a part of employee medical benefits. Not only must the mentally and morally healthy surrender their private spaces, but must also pay for the mutilations in group health plans. Worse, the city will now pay for transgender surgery for all uninsured residents. The moral indignation of the rest of society gets the blame for the suicide rate in transgendered patients.
And what of protecting our children in all of this? From CBS News:
California on Monday became the first state to enshrine certain rights for transgender kindergarten-through-12th grade students in state law, requiring public schools to allow those students access to whichever restroom and locker room they want.
Democratic Gov. Jerry Brown announced that he had signed AB1266, which also will allow transgender students to choose whether they want to play boys’ or girls’ sports. The new law gives students the right “to participate in sex-segregated programs, activities and facilities” based on their self-perception and regardless of their birth gender.
Supporters said it will help reduce bullying and discrimination against transgender students. It comes as the families of transgender students have been waging local battles with school districts across the country over what restrooms and locker rooms their children can use, disagreements that have sometimes landed in court.
The National Center for Lesbian Rights and the ACLU of California were among the bill’s supporters. Detractors, including some Republican lawmakers, said allowing students of one gender to use facilities intended for the other could invade the other students’ privacy…
…Karen England, executive director of Capitol Resource Institute, criticized the Legislature and governor for spreading “San Francisco values” throughout the state.
“The answer is not to force something this radical on every single grade in California,” she said.
She said the new law does not require students to prove they have a gender-identity issue, but rather requires school administrators to rely on students’ opinions of themselves. England also noted that there is no accurate way to gauge the effect of such policies because no uniform data on student or parent complaints is being collected. She predicted school districts will face lawsuits from parents of other children who feel their rights have been violated by the new law.
And so it goes. The forced “socialization” of our children as they are taught that reality is what anyone else on the fringes says it is, and the majority have no rights, that healthy revulsion is bigotry.
To be certain, it’s a complicated issue, and gender dysphoria is a many-tentacled monster. For a great insight by a man who had gender reassignment surgery and then reclaimed his male identity, and for his links to studies that indicate the failure rate in post-operative patient satisfaction, click here.
For now, we need to come to grips with the fact that four medical centers in our nation specialize in the short-term mutilation of gender-dysphoric children rather than long-term therapy for the most troubled of our little ones, that our schools are catering to the delusional thinking as well.
It’s a deadly game of dress-up for the patient, facilitated by clinicians and politicians who need the eggs.
Coming Home 
Examine your assumptions. “Natural moral law?” Really? God told you this? Puberty is a process of human growth under the influence of hormones. Why should human beings accept as their destiny physical changes the estrogens and testosterone in their bodies will produce? Why are they delusional, as you claim, because they wish another outcome?
“Cure” people who are transgendered? And how many have YOU cured? How many have been cured by _anyone_? The reason sex reassignment exists is because we cannot be cured. And of course, your desire to cure us supposes we have something to be cured of. We don’t.
You should go contemplate your navel before writing any more about something which you clearly know little.
Dallas,
Natural moral law does not require revelation. I suggest that YOU do your homework. As for not being curable, the 41% suicide rate suggests that transgendering is NOT the fix (pardon the pun). As for delusional thinking, yes, you are deluded if you think you are not chromosomal and biologically that which you were at birth. I suggest that you also look up the word delusional in the dictionary. We do not advance as a civilization by mutilating the delusional, most especially in childhood. You were owed better by people who knew better.
This is incredibly sad. How could these women allow this to happen to their son? We can never change or reproductive reality. What are they thinking? And why are people supporting them in this delusion?
Dr Nadal –
“As for delusional thinking, yes, you are deluded if you think you are not chromosomal and biologically that which you were at birth. ”
J Clin Endocrinol Metab. 2008 Jan;93(1):182-9
“A 46,XY mother who developed as a normal woman underwent spontaneous puberty, reached menarche, menstruated regularly, experienced two unassisted pregnancies, and gave birth to a 46,XY daughter with complete gonadal dysgenesis.”
Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Imperato-McGinley J, Guerrero L, Gautier T, Peterson RE. Science 1974 Dec 27; 186 (4170): 1213-5
” In an isolated village of the southwestern Dominican Republic, 2% of the live births were in the 1970’s, guevedoces (actually male pseudohermaphrodites). These children appeared to be girls at birth, but at puberty these ‘girls’ sprout muscles, testes, and a penis. For the rest of their lives they are men in nearly all respects. Their underlying pathology was found to be a deficiency of the enzyme, 5-alpha Reductase.”
Male–to–female transsexuals have female neuron numbers in a limbic nucleus. Kruiver et al J Clin Endocrinol Metab (2000) 85:2034–2041
“The present findings of somatostatin neuronal sex differences in the BSTc and its sex reversal in the transsexual brain clearly support the paradigm that in transsexuals sexual differentiation of the brain and genitals may go into opposite directions and point to a neurobiological basis of gender identity disorder.”
White matter microstructure in female to male transsexuals before cross-sex hormonal treatment. A diffusion tensor imaging study. – Rametti et al, J Psychiatr Res. 2010 Jun 8.
“CONCLUSIONS: Our results show that the white matter microstructure pattern in untreated FtM transsexuals is closer to the pattern of subjects who share their gender identity (males) than those who share their biological sex (females). Our results provide evidence for an inherent difference in the brain structure of FtM transsexuals.”
Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation Garcia-Falgueras A, Swaab DF Endocr Dev. 2010;17:22-35
“The fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in extreme cases in trans-sexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no indication that social environment after birth has an effect on gender identity or sexual orientation.”
etc etc. Feel free to contact me for a rather larger bibliography.
For a partial list of studies of effectiveness of surgery – studies that supposedly didn’t exist in 2004 according to a newspaper article quoted on a blog –
Sex Reassignment. Thirty Years of International Follow-up Studies After Sex Reassignment Surgery: A Comprehensive Review, 1961-1991 Friedemann Pfäfflin, Astrid Junge
An English translation is available online.
A rather later one is :
Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes – Murad et al – Clinical Endocrinology Volume 72, Issue 2, pages 214–231, February 2010
Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68–89%; 8 studies; I2 = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56–94%; 7 studies; I2 = 86%); 80% reported significant improvement in quality of life (95% CI = 72–88%; 16 studies; I2 = 78%); and 72% reported significant improvement in sexual function (95% CI = 60–81%; 15 studies; I2 = 78%).
A study focusing on younger patients is:
The treatment of adolescent transsexuals: changing insights. Cohen-Ketternis et al, J Sex Med. 2008 Aug;5(8):1892-7.
We seem to know from animal experiments and human studies that gender is more than xy vs. xx chromosomes. Some of ZE Brain’s first references are good examples of this phenomenon. We also find that deep psychological conflicts accompany gender dysphoria, and that the direction of the causal arrow is never fully clear. The latter statistics from ZE Brain do not reveal the fact that the paralyzing psychological issues almost always persist afer gender reassignment surgery, and that people may be unwilling to admit their gender dysphoria also was not lessened. It’s a complex issue, and these latter references are misleading. Based on what we seem to know at this point, the first intervention should always be intense psychological and spiritual counselling.
” The latter statistics from ZE Brain do not reveal the fact that the paralyzing psychological issues almost always persist afer gender reassignment surgery, and that people may be unwilling to admit their gender dysphoria also was not lessened.”
Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes,/b> – Murad et al – Clinical Endocrinology Volume 72, Issue 2, pages 214–231, February 2010
Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68–89%; 8 studies; I2 = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56–94%; 7 studies; I2 = 86%); 80% reported significant improvement in quality of life (95% CI = 72–88%; 16 studies; I2 = 78%); and 72% reported significant improvement in sexual function (95% CI = 60–81%; 15 studies; I2 = 78%).
Note though that quality of data is rated as “very low”. Many of the early studies showed poorer results, as surgery has improved so have outcomes, there are often no controls etc.
Note also that while HRT/Surgery can be regarded as a reliable cure for Gender Dysphoria, it does nothing to help with continuing problems from bullying, sexual assault, substance abuse etc. If a pastor or spiritual counselor is telling a patient to kill themselves to spare their family the shame of their existence, while this can spur them on to succeed out of anger, all too often the advice will be followed.
“The evidence in this review is of very low quality due to the serious
methodological limitations of included studies. Studies lacked bias protection measures such as randomization and control groups, and generally depended on self-report to ascertain the exposure. Our reliance on reported outcome measures may also indicate a higher risk of reporting bias within the studies. Statistical heterogeneity of the results was also significant.”
The authors continue with discussion of various limitations. Of course they mention reporting bias — who wants to admit that their somewhat irreversible surgery was a mistake? In any case, too many case reports in medline of psychological distress for which gender reassignment was no cure. When such reports involve a young person, or child, well…. all the “very low quality evidence” in the world will not persuade any reasonable person. I repeat (for the last time, by the way): the first intervention should always be intense psychological and spiritual counselling.
I repeat (for the last time, by the way): the first intervention should always be intense psychological and spiritual counselling.
Are you familiar with the medical standards of care?
For adults, a minimum 3 months of psychological testing and evaluation is required before hormonal treatment can be considered.
For minors, the minimum period is 2 years – usually many more than that, they must reach Tanner stage 2 before puberty-delaying medication is authorised..
A minimum of one year of psychological evaluation (and often counselling) is required after this initial period. For adults, this also requires one (two in some places) years of living as the target gender – but with the wrong genitalia – before surgery can be considered.
Surgery on minors is of course prohibited.
As for effectiveness of attempts to use “talking cures” – from the Standards of Care version 7 2011
Treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success (Gelder & Marks, 1969; Greenson, 1964), particularly in the long term (Cohen-Kettenis & Kuiper, 1984; Pauly,
1965). Such treatment is no longer considered ethical
For the same reason that attempting to use “spiritual guidance” as sole therapy for sucking chest wounds is considered unethical – it doesn’t work, and a large proportion of patients die without effective treatment.
In several studies this protocol has been evaluated[16–18]. From these studies it appeared that the youth who were selected for early hormone treatment (starting between 16 and 18 years) no longer suffered from gender dysphoria, and that 1–5 years after surgery, they were socially and psychologically functioning not very different from their peers. Their scores on various psychological instruments, such as a shortened Dutch form of the Minnesota Multiphasic Personality Inventory and the Symptom Check List-90 [19], were considerably more favorable than scores of a group of subjects who had been treated in adulthood in the Amsterdam clinic, and scores were in the normal range as compared to normative samples. By contrast,
there was also a cohort of adolescents presenting with gender dysphoria, who after longterm assessment (which, depending on the degree of gender dysphoria and nonrelated pathology, could take a year or even longer) were not deemed eligible for early treatment, and they did not pursue SR at later ages. So, the burden of the GID, the unabating pursuit of SR, and clinical assessment provided by our clinic appeared to provide acceptable selection criteria for good candidates for SR before adulthood.
16 Cohen-Kettenis PT, van Goozen SH. Sex reassignment of adolescent transsexuals: A follow-up study. J Am Acad Child Adolesc 1997;36:263–71.
17 Smith YL, van Goozen SH, Cohen-Kettenis PT. Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery:
A prospective follow-up study. J Am Acad Child Adolesc Psychiatry 2001;40:472–81.
18 Smith YL, van Goozen SH, Kuiper AJ, Cohen- Kettenis PT. Sex reassignment: Outcomes and predictors of treatment for adolescent and adult transsexuals. Psychol Med 2005;35:89–99.
19 Kuiper AJ, Cohen-Kettenis PT. Sex reassignment surgery: A study of 141 Dutch transsexuals. Arch Sex Behav 1988;17:439–57.
– Cohen-Ketternis et al, J Sex Med. 2008 Aug;5(8):1892-7.
Self-reporting – which may be subject to bias – is not the only method used.
The therapy I’m advocating is not aimed at trying to change a person’s gender identity (in your zeal to cut and paste from other sources, you somehow misread my comments). It’s aimed at treating the almost universal psychiatric illness that accompanies this type of dysphoria. 2 years is a short time in therapy for a child, and there is a vast range of therapeutic skill and effectiveness, even with therapy of much longer duration. If you are limited to cut-and-paste here, let me do the same. Here is one — if you want to discuss further, please let me know. Provide your email address and let’s have at it. I’ll not waste any more of Dr. Nadal’s valuable real estate on cut-and-paste arguments.
by Keith Ablow, MD
Chaz Bono, the “transsexual” woman who underwent plastic surgery and takes male hormones in an effort to appear to be a man, and who asserts she is a man, will appear on the upcoming season of “Dancing with the Stars”, according to ABC, the network which airs the show. He will be partnered with a woman.
Casting Chaz Bono on “Dancing with the Stars” is part of Chaz’s victory tour, which has included appearances on talk shows and the release of a book called “Transition.”
I advise parents to not allow their children to watch the episodes in which Chaz appears.
Here’s why: Many of the children who might be watching will be establishing a sense of self which includes, of course, a sexual/gender identity. Some will be girls becoming comfortable with dramatic changes in their bodies. Some will be boys coming to terms with integrating the dawn of manhood with exquisite feelings of vulnerability. Young viewers will include tomboyish girls and sensitive, less stereotypically “masculine” boys. They will also include children who have sustained the losses of loved ones and are wrestling with depression, perhaps wondering who they are absent their deceased mothers or fathers.
The last thing vulnerable children and adolescents need, as they wrestle with the normal process of establishing their identities, is to watch a captive crowd in a studio audience applaud on cue for someone whose search for an identity culminated with the removal of her breasts, the injection of steroids and, perhaps one day soon, the fashioning of a make-shift phallus to replace her vagina.
It is a toxic and unnecessary byproduct of the tragic celebration of transgender surgery that millions of young people who do watch “Dancing with the Stars” will have to ponder this question: Maybe my problems really stem from the fact that I’m a girl inside a boy’s body (or a boy inside a girls body). Maybe I’m not a tomboy; I’m just a boy! Maybe I’m not just being bullied because I’m a sensitive, reflective young man interested in flowers, not football. Maybe I’m not just uncertain about my sexuality. Maybe I’m a girl! Maybe all this angst and suffering I’m feeling as I emerge into puberty and pass through it isn’t just because I’m changing, but because I should change completely—and have my breasts removed or my penis amputated!
It would be wrong to think that gender dysphoria cannot be kindled by celebrating those who have undergone sexual reassignment surgery. Human beings do model one another—in terms of emotion, thought and behavior. By broadcasting, applauding and mainstreaming the journey of a very disordered person who endured, and likely will continue to endure, real suffering based on extraordinarily deep psychological problems, we suggest that that journey is a smart—even heroic—one to take.
The truth is that Chaz Bono should be empathized with and treated with dignity. Any contribution he makes to the world should be applauded as it would be for any other person.
But Chaz Bono should not be applauded for asserting she is a man (and goes about trying to look like one) any more than a woman who believes she will be happier without arms, has them removed and then continues to assert that she was right all along—her self-concept was that of a double amputee. Now, all is well.
Chaz Bono should not be applauded any more than someone who, tragically, believes that his species, rather than gender, is what is amiss and asks a plastic surgeon to build him a tail of flesh harvested from his abdomen. If only a plastic surgeon would acquiesce, all would be well.
There are such people, by the way. Do you want them exalted, too, rather than commiserated with? Do you want your children thinking that if they suffer a delusion that they are better off without arms, that that means they should visit a plastic surgeon? Or would you prefer that they burrow to the psychological core of their abnormal psychology with an empathic professional, or two or three—even if that exploration is long and arduous? Would you not prefer that they try every available medication to impact mood, thought and perception before going under the knife?
It would be wrong to think that gender dysphoria—discomfort with one’s gender—must always end either in misery or sexual reassignment surgery. It can end with coming to terms with deep psychological conflicts that are fueling the gender dysphoria.
“Dancing with the Stars”, starring Chaz Bono, takes the opposite view. It’s position is that Chaz Bono’s chemically and surgically altered appearance is a blessing to us all, a triumph of autonomy and self-possession on par with the triumphs achieved by the heroes of the Civil Rights movement.
That’s very nearly insane. It’s a psychologically destructive myth and can erode our children’s evolving senses of self.
I’m going to take heat for saying all this, by the way. I already have for making similar statements in the past. So be it. I would rather be the one shouting “The Emperor has no clothes!” than one of the happy-go-lucky villagers applauding the tragic parade.
Make no mistake: I would have gone to the ends of the earth to help Chaz Bono if she had come to me for help.
I would have treated her with dignity and summoned every ounce of my intellect and empathy to explore her psyche with her. I would have pried loose every family secret hidden by the Bonos.
I would have been relentless.
I would have used everything I know about medication to help her.
I would have enlisted the help of every expert I know—some of the world’s best—at everything from endocrinology to hypnosis.
I would have teamed up with a spiritual counselor, if that seemed indicated.
And if all that failed, and if Chaz Bono wanted either to kill herself or to undergo gender reassignment surgery, I would have taken that journey with her, too. I would have talked her parents through the hell of it. We would make the best of it.
Somehow, with enormous compassion and love and God’s help, we would get through it.
But I would feel no triumph in it, no sense of any heroic overcoming obstacles and righting the flesh in accordance with the soul. I would feel pathos. I would feel the limits of my attempts to truly heal Chaz Bono, and I would wish her well with a life that had veered, seemingly unavoidably, into a very dark place.
Chaz Bono didn’t come to me for help, though. She didn’t ask me for my opinion. But when she decided to promote gender reassignment surgery in the media as a happy triumph, she ended up getting my attention, anyhow. Because I care about you, too, and your families.
So, here it is. One psychiatrist’s prescription, sure to cost me a lot of hate mail, but reward me with the certainty that I am stating what I believe to be true and that I am doing my job: If you care about your kids, don’t let them watch “Dancing with the Stars” starring Chaz Bono.
It would be wrong to think that gender dysphoria—discomfort with one’s gender—must always end either in misery or sexual reassignment surgery. It can end with coming to terms with deep psychological conflicts that are fueling the gender dysphoria.
The problem here is that there’s no good quality evidence that “deep psychological conflicts” fuel gender dysphoria, and plenty of evidence that, at least in the general case, they do not. Dr Ablow’s opinions were “state of the art” back in the 70’s, based on a handful of case reports. Since then, we have hard data that contradict those conjectures.
A better quote might be that from Dr Paul McHugh, former advisor to the Vatican:
We need to know how to prevent such sadness, indeed horror. We have to learn how to manage this condition as a mental disorder when we fail to prevent it. If it depends on child rearing, then let’s hear about its inner dynamics so that parents can be taught to guide their children properly. If it is an aspect of confusion tied to homosexuality, we need to understand its nature and exactly how to manage it as a manifestation of serious mental disorder among homosexual individuals
Such searches have been conducted for over 60 years, without success. There is apparently no “there” there to find. Instead, there is increasing evidence of biological causality in humans, proof of biological correlation in humans, and proof of biological causality in animals.
Dr McHugh then goes on to say:
But instead of attempting to learn enough to accomplish these worthy goals, psychiatrists collaborated in a exercise of folly with distressed people during a time when “do your own thing” had something akin to the force of a command.
This is not an evidence-based position, but an ideologically-based one. It ignores the many fruitless studies looking for a psychological cause, and the evidence from studies such as this:
A sex difference in the human brain and its relation to transsexuality. by Zhou et al Nature (1995) 378:68–70.
Our study is the first to show a female brain structure in genetically male transsexuals and supports the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones
Clinical Implications of the Organizational and Activational Effects of Hormones M.Diamond Hormones and Behavior 55 (2009) 621–632
The organization-activation theory posits that the nervous system of a developing fetus responds to prenatal androgens so that, at a postnatal time, it will determine how sexual behavior is manifest. How organization-activation was or was not considered among different groups and under which circumstances it is considered is basically understood from the research and comments of different investigators and clinicians. The preponderance of evidence seems to indicate that the theory of organization-activation for the development of sexual behavior is certain for non-human mammals and almost certain for humans.
Dr McHugh’s position was : Decision first, search for evidence afterwards, as he himself admits.
This interrelationship of cultural antinomianism and a psychiatric misplaced emphasis is seen at its grimmest in the practice known as sex-reassignment surgery. I happen to know about this because Johns Hopkins was one of the places in the United States where this practice was given its start. It was part of my intention, when I arrived in Baltimore in 1975, to help end it.
Dr Ablow studied under Dr McHugh, and was taught this by him. Unfortunately, neither of them have kept up with the state of the art since, possibly because that would contradict their pre-conceived beliefs. Dr Ablow’s resignation from Professional Associations subsequent to his writing this article due to his ideological convictions would suggest that.
It is germane that Dr Ablow’s article was on a PopSci media site, and Dr McHugh’s articles have been in religious journals. As ideological opinion pieces, they are outstanding. As science or medicine… not so much. The unevidenced assertions would never get through even cursory examination.
Germane? Do you use words like that in your scientific publications? You don’t use “relevant?” Well, you and I don’t write for the same journals. Fine. Ablow is a professional. A good one. Nothing you said above is “germane.” You somehow know what people keep up with — good pseudoscience on your part (telepathy?). We know about hormones and gender. We know about relative digit length and exposure to hormones in the womb (and homosexuality). We know about the differences in female and male brains. However, nothing — absolutely nothing — you said above contradicts what he said. Are you a transgender? Then perhaps you have a different perspective. If not, you seem more a political activist. It is you who throws out junk science and has somehow seen fit to ignore the individual. Ablow still treats individuals, by the way. There are no broad prescriptions, unless you’re caught in Obama’s politics. I don’t mind discussing the issue with you, but you can do MUCH better than that! Ablow, at least, had something to say.
Science or medicine? Are you joking? The rubbish you cite — how did it get through peer review? If that is what you think, most of Sigmund Freud doesn’t meet your definition of science, and science by your definition is all that is important, and is therefore meaningless. 30 years of practice means nothing. ZE Brain, who can use the words “germane” instead of relevant, and “cursory” — ha! I can just see your mental notes: “Point is weak, use big vocabulary.” Do you actually publish what your website says? Don’t they care a wit in your field for competent writing? Nonetheless, I firmly believe that fetal hormone exposure determines some (but not all) adult sexuality. It doesn’t change one iota of the cautions expressed by Dr. Ablow. Too many would have surgically built a tail (believe him on that!) and chopped off some appendages to satisfy their warped concept of themselves. Completely analogous (big word for you, Brain!) to human sexuality? Nothing is. The need for caution? Just as important. Bravo Ablow! Bravo!!!!
Dr. Nadal … this post hits home … is there a way I can email you privately?
pt-109, Two of your comments were sitting in the spam folder. I just moved them.
Dr Nadal – thanks for publishing pt-109’s comments.
pt-109 – I’m not Trans, I am Intersex though. Perhaps Dr Nadal can explain about the 3BHSD form of CAH, and what is likely to happen if 3beta hydroxysteroid dehydrogenase is deficient. Wiki’s not too bad on it though.
I’m also Australian – our vocabulary is a bit different from US standard, closer to UK standard English.
As regards Dr Ablow – he has claimed that Gender Dysphoria can be induced by merely seeing a Trans person, has he not?
I’d agree there.
Male–to–female transsexuals have female neuron numbers in a limbic nucleus. Kruiver et al J Clin Endocrinol Metab (2000) 85:2034–2041
— The present findings of somatostatin neuronal sex differences in the BSTc and its sex reversal in the transsexual brain clearly support the paradigm that in transsexuals sexual differentiation of the brain and genitals may go into opposite directions and point to a neurobiological basis of gender identity disorder. —
A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity. by Garcia-Falgueras et al Brain. 2008 Dec;131(Pt 12):3132-46.
— We propose that the sex reversal of the INAH3 in transsexual people is at least partly a marker of an early atypical sexual differentiation of the brain and that the changes in INAH3 and the BSTc may belong to a complex network that may structurally and functionally be related to gender identity. —
Increased Cortical Thickness in Male-to-Female Transsexualism Luders et al,Journal of Behavioral and Brain Science, 2011
— Abstract:
Results: Results revealed thicker cortices in MTF transsexuals, both within regions of the left hemisphere (i.e., frontal and orbito-frontal cortex, central sulcus, perisylvian regions, paracentral gyrus) and right hemisphere (i.e., pre-/post-central gyrus, parietal cortex, temporal cortex, precuneus, fusiform, lingual, and orbito-frontal gyrus).
Conclusion: These findings provide further evidence that brain anatomy is associated with gender identity, where measures in MTF transsexuals appear to be shifted away from gender-congruent men. —
etc etc
I think it would be stretching rather a long bow to say that these differences can be induced by merely watching a trans person on TV. Especially since we know from autopsies of late-term miscarriages that some are visible pre-natally in cis-sexual babies.
Finally – my own scientific publications are in a completely separate area, non-medical, not even biological (apart from Artificial Life). Pure mathematics, Computer Science, Quantum Physics and Chemistry.
Articles like
Optimization of a Genetic Algorithm for the Functionalization of Fullerenes MA Addicoat, AJ Page, ZE Brain, L Flack, K Morokuma, S Irle
Journal of Chemical Theory and Computation 8 (5), 1841-1851
and
Optimization of a genetic algorithm for searching molecular conformer space ZE Brain, MA Addicoat The Journal of chemical physics 135 (17), 174106-174106-10
Sorry for not responding sooner to your thoughtful comments (mine were less thoughtful, and spam is probably a good place for them). Actually, I’ve had to worry about my own publications this week, as my job unfortunately depends on them, and I’ve been a slacker recently. I’d much rather argue with you than write another boring paper. But I must say that my target audience is different from yours — in a good way, and in a bad way. Frankly, I wish my audience was as intelligent as yours. For example, I wish my readers could fathom the functionalization of fullerenes, or even the fumigation of tangerines. However, my readers don’t tolerate jargon very well, or highfalutin language in general. Perhaps that is a good thing. Now, where the heck was I? Oh, yeah. Again, I do believe that human sexuality is a complex mixture of nurture and nature, and I’m sure Dr. Ablow believes this as well. What I endorse in his “piece,” based on years of clinical practice, is not that variation of sexuality out of the “norm” is always morally wrong (which he didn’t say), but that there is a huge range out there of people who would change something about their physical body to deal with psychological issues. Michael Jackson is just one of so many examples. Not just his self-mutilation through plastic surgery, but also his apparent sexual attraction to young boys. I’m not judging the morality of it, by the way, just noting the complex ways that human sexuality and psychological pathology can mix. The ways are infinite, actually. What I realize is that we must move very cautiously, moreso than we are doing now, to truly treat individuals as individuals and not syndromes, or political pawns. It’s late and I’m rambling, I admit it. But does that make any sense, ZEB?
PS: I know about androgen insensitivity syndrome (since the time I dated a med student), and realize there are several related conditions that can lead to intersex. The exact mechanism that you mentioned above is new to me. As to whether Dr. Nadal will explain it to me, I’m not sure, because I’m still waiting for him to explain to me why little girls are a whole lot bossier than full grown men. Nonetheless, please understand that I have no underlying prejudice or qualms (for lack of better words) about these issues. The complexity of it all fascinates me; I’m awestruck. And the more we know, the more we will know that we don’t know. In the evolution of knowledge, let’s never lose sight of the individual. That is not as easy as it sounds. Dr. Nadal has had an influence on my thinking about abortion, and some of his most profound arguments (unless I completely misunderstood them, which is highly likely) had to do with awareness of the fundamental individual, when time and space are peeled back to reveal all that he or she really is. Oh, man, I’m getting old… I can’t seem to pull these all-nighters any more…. I’m actually dizzy with tiredness. Let me finish with a little poem, one I wrote to express in this intimate forum the depth of my innate multiplex sexuality:
Roses are red
Violets are blue
If you’ve got female body parts….
How do you do!
[pt-109, I will indeed engage these arguments over the weekend. Been very busy with my own writing for publication. The last line of your poem reads very differently depending on whether you use a question mark or explanation point, but I digress… All the best to your lovely wife and beautiful children. Gerry]
You’re the greatest Gerry! Our best wishes to you and your family always!
Seconded.
BTW- Michael Jackson had both Vitiligo,and Lupus. I’m sure Dr Nadal can tell you the possible effects of those on connective tissue and skin. Plastic surgery to repair facial lesions from the Lupus is not uncommon – nor always successful.
The effects of Vitiligo on skin pigmentation are also both spectacular and well known. Two of the nastier auto-immune diseases, Lupus especially.
However – none of that fit the lede of “Whacko Jacko”., so while he’d been diagnosed as early as 1993, and even been interviewed on TV about it, it was, if not exactly hidden, not emphasised by the media. People aren’t interested in someone in chronic episodic joint pain, with photosensitivity, skin bleaching and disfiguring facial lesions.
As for Dr Ablow’s clinical experience – like most psychiatrists, he’s never as far as I know treated a Transsexual patient. Assuming 300 new patients a year, he’d have to practice for at least 10 years (or 100 by the official estimates) on average just to see one case. In fact most patients go to specialists direct from a PCP, so it’s even more unlikely. Those mental health professionals with no experience in the area often have some peculiar, even eccentric, ideas about it. The good ones refer patients to therapists who, you know, know what they’re doing
Intersex people are in a similar situation. Some conditions are 1 in 100,000.or rarer. Even specialist endocrinologists are unlikely to see more than one such case in their lifetimes. Possibly the most common single condition is 47,XXY, which unless it leads to Klinefelter syndrome (the two terms are often used interchangeably, but 47,XXY can be asymptomatic) is unlikely to be recognised. That’s 1 in 450 in males, no good estimate in females but thought to be 1 in a ten thousand or so. All estimates of prevalence should be taken with some mg of NaCl.
As I’m a member of a number of Intersex support groups, and in contact with a number of researchers, I know more Intersex people than most. But I met the first functional 48,XXXY person I’d ever encountered just last week. OTOH one of my co-authors is a 46XX/46XY chimera.with classic Blaschko’s lines. Only diagnosed in his late 20’s from a cheek swab experiment taken out of personal curiousity.
Thank you for your reply ZEB. We’re kinda having two separate conversations at this point, so l’ll gladly switch over to yours. Yes, it’s rare; it’s all rare; everything is rare. Yes it’s complicated; it’s all complicated; everything is complicated. Yes, you have every right to make statistical inferences regarding Dr. Ablow’s patient history. Yes, he couldn’t possibly know what he’s doing or talking about, because of those statistical inferences you have so wisely made. Yes, you have every good sense to believe the diagnoses that Michael Jackson claims he had. Yes, all of Michael Jackson’s surgeries were based entirely on correcting physical ailments, rather than a misguided attempt to correct psychological ones.
You see, we agree on everything! And it was really quite simple too! Absurdly simple: All I had to do was to benumb every ounce of reason and sanity that I possess.
Why not ask Dr Ablow if he’s ever treated a patient diagnosed as Transsexual under the ICD-10, or with GID under the DSM-IV-TR?
Nothing beats an experiment.
Zoe, your writing style (at least here) is a little unstructured. First you ask a facetious question. OK, I’ll be nice and answer it: because I don’t have his telephone number. Second you say that nothing beats an experiment. However, who knows to what you are referring — is the experiment whether or not I will try to call Dr. Ablow? If not that, what?
Anyway, Zoe, you should know by now that a ham sandwich beats an experiment. After all, as you said, nothing beats an experiment, and a ham sandwich is certainly better than nothing. Q.E.D.
You could try contacting Dr Ablow via Facebook. https://www.facebook.com/keith.ablow.7?fref=ts
Re ham sandwiches – the few that haven’t been indicted by grand juries – the proof that a horse has 6004 legs:
The mathematical set (Horse) contains 4 more legs than the set no (Horse).
No horse has 6000 legs.
Parenthetically… you have no idea how good it is to engage in rational debate with someone who exhibits goodwill and a sense of humour.
Zoe, if I’m going to cold-call a psychiatrist from the popular news media, it will likely be Charles Krauthammer, if I ever get up the nerve. I think he’s amazing. Anyway, I see your point about the horses. But ham doesn’t come from horses. I’ve know people to squeeze water from a stone, and make gold from lead, but never have I seen someone get a ham sandwich from a horse. Except, of course, “Jose*,” the cook in our faculty dining room…
(* name withheld for security reasons)
I thought Jose cooked for us!
You have faculty dining rooms? Luxury!
Though the lounge room we share with the CSIRO does have facilities for cooking Ramen noodles. And a fridge to store your milk. A coffee machine – bring your own filters and coffee. We pay $65 a semester in compulsory “facilities charges” for those.
For those living large – there’s a Subway within walking distance, but brown-bagging and eating at your desk is usual.
Krauthammer is good value. A healthy democracy needs two sane parties to choose from – otherwise the electorate will opt for the sane crooks and machine politicians rather than an even worse alternative. The DNC has been allowed to get away with murder – or at least, grand theft.
Just look at the Va Governor’s race. Short of nominating Albert De Salvo, it’s difficult to see how the DNC could choose anyone more unpopular (also venal, corrupt etc) than Terry McAuliffe. But…
“In an opinion piece titled “Our choice for governor in 2013: None of the above,” the (traditionally Republican) Richmond Times-Dispatch said it could not “in good conscience endorse a candidate for governor.”
You’re in Australia reading about our local politics? What’s up with that? Just knock it off, you’re giving me the creeps. De Salvo was not corrupt, by the way (not really smart enough), just a bit “rhapsodic” when pursing his career goals. Now Jose, on the other hand, he’s smart, and very corrupt, but also very honest — when Jose says he’s “going to see a man about a horse,” he ain’t kidding. Speaking of Jose, I was on North Bondi beach not too long ago, with my sister who is an attorney in Sydney, and we were dining at a little place called Mojo’s Tapas Bar. I had a ham sandwich there that — perhaps I was imagining things — tasted somehow familiar. To show how the sun had put a strain on my senses, I though for a second that I saw a familiar triangular shaved head in the shadows behind a curtain in the kitchen, a asymmetric waxy veneer as it were, inlaid with a pair of beady black eyes that I surmised to be the last things “Shergar” ever saw. I darted into the kitchen clutching the remnants of bread and mustard, at least that which was not already providing a rather interesting texture to the silk ascot of my Robert Hall smoking jacket, but found nothing there but an open door in the back and some half-eaten (and still steaming!) empanadas. Upon my return to the US, there he was, ast his usual stool in the faculty dining room. For a second our eyes met (oh, those eyes!), and he gave me what appeared to be a knowing smile and a cagey wink… You know, I think I might give Ablow a call after all!
I am not worthy.
Before replying, I’ll have to stop rolling on the floor in helpless laughter.