The western scientists are absolutely terrible at understanding psychological problems so everything is re-framed as a physiological problems ("it's a chemical imbalance", "you were born with wrong physiology" etc.), which they have mastered.
If someone is raised in a cult, do you change the world to fit that person in or do you help that person fix their beliefs?
The same rule should apply for kids raised in other types of abusive households.
To someone raised in a cult, or with deeply held beliefs, there is very little difference between the two. In fact "fixing beliefs" is, in a sense, reality resculpting. We are our priors. A large part of our priors are the contents of our mind.
Honestly, I shudder at the isea we ever figure out how to "engineer" a belief into a person. As it stands, that is one technology we are not ready to have trivially available.
And yet, the media framework have engineered the beliefs that the large masses should think one particular way when it comes to these things very successfully.
I've got to agree with Spivak that this feels a bit like fearmongering. Assuming this person transitioned in the 1990s based on age, the standards of care were... problematic.
This probably would have been the Harry Benjamin Standards of Care, 1990 edition[0], which I will link, but I can't really stomach trying to read/summarize.
The fact is the regret rate for gender affirming surgeries less than 2% [1]. Absolutely heartbreaking for those it happens to, but hip replacements have a significantly higher regret rate.
As to this article in particular, I will note:
* Most of the health risks associated with taking supplemental estrogen are specific to the oral route. Transdermal (gel or patches), injected, or subcutaneous pellet implants avoid the risks of blood clots and stroke.
* There is likely nothing stopping the author from taking supplemental testosterone in addition to, or instead of, estrogen.
For context, I'm a transgender non-binary person in my 30s. I started transitioning a few years ago, and had non-conforming gender affirming surgery this past September. If anyone is interested in details, I've written about it elsewhere[2]. To my knowledge, I am the only person publicly out about having had that particular procedure done.
Under the medical standards of care prior to WPATH v7 (2012)[3], I would have been denied care unless I did a lot of lying and performative gender things that I would have found distressing at best. There are still major issues with the standards of care, but they've definitely improved.
While I've had some post op complications that I'm not happy about (which aren't my surgeon's fault), I have every reason to believe that they're fixable, and if I had to make the choice over again, I'd have still done it.
My HRT includes a combination of estrogen, progesterone, and testosterone. I've largely been able pick which primary and secondary sexual characteristics I want for my body. My appearance these days frequently leaves people unsure of my gender, which I find affirming.
There’s a lot to unpack here and I want to have a discussion about the actual interesting bits.
> I once believed that I would be more successful finding love as a woman.
Holy yikes Batman.
> In high school, when I experienced crushes on my male classmates, I believed that the only way those feelings could be requited was if I altered my body.
And there you have it. This person tried to “trans the gay away” and regretted it. Zero percent shocked.
> I had to persuade two therapists, an endocrinologist and a surgeon to give me what I wanted.
This is the meat here. There are a shit ton of safeguards to make sure people aren’t making the wrong decision but you can learn to make all the right sounds for the therapists, psychologists, and doctors and lie your way through anyway. I’m so unbelievably sorry that this guy misdiagnosed his internalized homophobia as self image issues as dysphoria and has to live with that but his experience isn’t universal.
> I know now that I wasn’t old enough to make that decision
The subtext here being that no one is old enough to make that decision. Which isn’t true at all. I have trans friends who have known since elementary school. Confidence has more to do with time lived “out to yourself” and living as your post-transition gender than age.
> yet that was the person who committed me to a lifetime set apart from my peers
Not at all surprised at his feelings when that’s how he views his situation. He’s at absolute worst essentially a better passing pre/no-op trans man, who go on to live happy fulfilling lives.
> I must choose between the risks of taking exogenous estrogen, which include venous thromboembolism and stroke, or the risks of taking nothing, which includes degeneration of bone health. In either case, my risk of dementia is higher, a side effect of eschewing testosterone.
>
Or he could take testosterone like a trans man and not deal with this at all. Also the scary side effects of low T and and high E is the reality of every woman. Making a mountain out of mole hills. Also must suck for everyone with hormone deficiencies, chronic migraines, adhd, seasonal allergies, or cancer, who have to take pills even day. Guess they’re all lifetime medical patients too.
> I didn’t need parents questioning me or establishing realistic expectations
Ughh this is the most post-hoc reasoning I’ve ever seen. If this guy was actually trans and it worked out well for him and he lived a happy life it would literally be the opposite story for the same events.
> I’m also alarmed by how readily authority figures facilitate transition
No he isn’t because he hasn’t gone though the process in 2022. He has an idea informed by the internet on how the process surely must go. You can’t get GRS without two separate psych evals, a doctor sign off, and you have to be living as your post transition gender for at least a year. Even HRT with “Informed Consent” which is the least restrictive doctors still refer you to a therapist to talk with you before any of the effects kick in and is only available for 18+. For anyone younger you still have to have a psych eval and parental consent. If you think psychologists aren’t challenging people who come in for dysphoria symptoms you’ve never talked to a trans person whose had to deal with the rampant gatekeeping.
I know this will come off as petty but come on dammit. Hang out in some queer spaces for like 2 seconds and you’ll know that the reality of trans folks really is.
I am very pro-trans-rights. But your response here comes across as insanely dismissive to the point of being insensitive. This person is sharing their lived experience with the world, and based on a couple of sentences of attempting to remember what they felt like 30 years ago, you diagnose them with internalized homophobia? That is so shockingly disrespectful to this person.
They didn't say nobody should have gender affirmation surgery, they didn't even say they fully regret it. They shared their experience. Have some respect for the life this person lived.
If that comes across in the tone, it's not my intention. I have absolutely not one iota of issue with their lived experience. Their story is super important to help people figure themselves out. It's only when they start giving advice that is misinformed or assumes that their experience is universal. The conclusion should be "if you're reading this and your story sounds like mine, then maybe take some time to figure yourself out."
I'm not diagnosing them with internalized homophobia, that's literally what they described. They also had to deal with a metric fuck ton of external homophobia too. It's not a bad word, everyone gay person has it to some degree. If you think that bit is some character assassination I assure it isn't. Talking about internalized homo/transphobia inside the community has a completely different denotation then someone calling a bigot homophobic on Twitter.
I appreciate that you were not meaning to come across that way, which is why I was careful not to call _you_ insensitive etc. All advice comes from a place of personal and learned/observed experiences. To assume this person is not active in the queer/trans community is also without merit.
I am not saying it is or what intended to be a character assassination. Two points, the first is that it is still an assumption, and I realize it is something that aligns with internalized homophobia but it is still more fair to say "sounds like" rather than "is". The other point is that you are addressing a community that may not be familiar with terminology, usages and the such within the queer/trans/+ community. It isn't a fault of the reader, they can only go by what they have heard/experienced. For a vast majority of people who may be reading this, being called homophobic will get them defensive right away, even if your _intent_ was to call something what it is.
I am not trying to dissuade you from your point but rather trying to explain ways that the same point could be made in a more welcoming, educational way.
Ya know what, that’s all a totally fair criticism. I edited my comment to soften the tone quite a bit and make it less matter of fact but the edit window ran out. I wrote a very Tumblresque comment when HN usually requires more sensitivity; didn’t really write to my audience.
I can't tell you how much I've appreciated this interaction, especially on the Internet. Two people earnestly discussing a sensitive topic and nobody yelled or cussed or went H.A.M. Thank you!!!
That is great, but if a co-worker has gender affirmation surgery and changes their name and pronouns, you might want to have some empathy and understanding of the process.
My perspective:
The western scientists are absolutely terrible at understanding psychological problems so everything is re-framed as a physiological problems ("it's a chemical imbalance", "you were born with wrong physiology" etc.), which they have mastered.
If someone is raised in a cult, do you change the world to fit that person in or do you help that person fix their beliefs?
The same rule should apply for kids raised in other types of abusive households.