Friday, September 25, 2015

Transgender Delusion

Richard Corradi is a professor of psychiatry at Case Western Reserve University School of Medicine. He has an article in the current issue of First Things (subscription required) in which he pretty much excoriates his own profession for what he sees as an abdication of their professional responsibility. Psychiatrists and psychologists have been so intimidated by the politically correct, Corradi claims, that they've failed to call mental illness by its name when it comes to issues of sex and gender.

Here are some excerpts:
Human nature does not change. Despite our postmodern sophistication and our wishful thinking about perfectibility, our nature is immutable—not least in its fickleness, its embrace of irrational ideas and practices, and its suggestibility.

The medieval field of alchemy—the attempt to change base metals into gold and to find the philosopher’s stone capable of bringing about human perfection, even immortality—is ludicrous to the modern mind, a relic of a prescientific time. Yet the ancient belief in transmutation is still with us. Current popular delusions are aspirations not to turn base metals into gold, but rather to transcend the laws of biology and transmute human nature. Among them is the popular belief that gender is fungible, so that whether we are born male or female is of no consequence.

Now consider one of our current popular delusions: that gender is a social construct rather than a biological fact. This is the notion that there are no biologically determined characteristics of either sex—that “male” and “female” are socially assigned roles. According to this worldview, a person is not simply male or female. In fact there are no “opposite sexes,” only a gender spectrum between femaleness and maleness (hence the prefix “trans-” in “transgender”), and one may choose to identify oneself with any point on the continuum, or to remain undecided.

This delusion has infected groups that are presumed to be the most highly educated, sophisticated, and worldly-wise in our society.

Another manifestation of denial of the biological differences between the sexes takes the form of a man’s declaring, in effect, “My gender is what I say it is. I feel like I’m a woman in a man’s body, and I demand that I be treated like one.” The demands that society accommodate such absurd personal delusions are becoming ever more aggressive. We see municipal and school authorities, for example, scrambling to mediate conflicts about gender-neutral bathrooms and shared locker rooms, fearful of being labeled as bigots, or sued, if they do not comply.

If someone wonders whether a middle-aged man who declares that he is a woman and demands the use of public female restrooms might be mentally disturbed, that doubter had better not voice her concern publicly; she risks not only being labeled a bigoted denier of civil rights but also having her business boycotted.

The entire spectrum of gender dysphoria disorders is treated as though it were an authentic lifestyle choice unreasonably suppressed by a bigoted majority.

It is lamentable that American psychiatry has abrogated its professional role and allowed public hysteria to define the transgender phenomenon. This deprives people of treatment that could lead them to understand themselves and take control of their lives, rather than be passive victims of a one-size-fits-all fad.... Transient developmental crises that would be amenable to appropriate psychotherapy are turned into profoundly life-altering, irreversible physical mutilations.

[A]norexia nervosa is a multidimensional disorder, similar to transgenderism in that it involves a profound dissatisfaction with one’s body. However, seriously underweight anorexic patients who see themselves as obese are not treated with weight-reducing liposuction by physicians who go along with their irrational belief. Instead, anorexia is treated as a psychiatric illness.

Another body dysmorphia that is currently receiving some notoriety—and acquiring a constituency that would like it to be included in the DSM—is “Body Integrity Identity Disorder” (BIID). Also known as “transableism,” BIID is the desire of an able-bodied person to become disabled—by a limb amputation, or by being blinded, rendered deaf, or even paralyzed. One hopes that common sense, which judges such a desire as grotesque, will prevail over those who would regard it as just another lifestyle choice. The wish to be rid of an offending limb is remarkably similar to the wish of a transgender man to be rid of an unwanted penis.

That purported experts on mental illness should enable the acting-out of a cultural delusion is egregious enough. Most flagrant, however, is their treatment of a mental disorder with mutilating surgery. What can my colleagues be thinking when they prime patients with hormones and prepare them for surgery? Are they themselves delusional, and do they believe that they can change women into men (and vice versa)? Do they think that surgery should be the treatment of choice for people who are dissatisfied with themselves? Have they forgotten, or did they never learn, about psychotherapy, a cornerstone of psychiatry that helps patients understand themselves and their experiences so that they can take control of their lives? Clearly the disaster of a previous attempt to treat mental illness with surgery—prefrontal lobotomy—has not served as a lesson.

Lest common sense fail to convince readers that surgery is not a treatment for a mental disorder, a Swedish study published in 2011 found that over the long term, 324 people who had ­undergone sex-­reassignment surgery demonstrated an alarmingly high suicide rate and experienced considerably higher numbers of ­severe ­psychiatric problems than were present in the general population.
All of this may lead the reader to wonder why it is that psychiatrists are so reluctant to call some neuroses disorders but shrink (pardon the pun) from labeling others as disorders which are similar but in one way or another involve sex.

Perhaps the reason lies in the fact that once we determine that any sexual expression is "good" we put ourselves on a slippery slope which offers us no stopping point at which we can say "no further." On the slippery slope of "sexual freedom" no sexual expression is "wrong." Indeed, in a society that has largely rejected the idea of any objective moral right and wrong about anything, let alone sex, there remains no ground upon which to stand to say that anything at all is morally perverse.

Unless, matters change and sanity is restored, we can expect in the not too distant future to see calls for the legalization of polyamory, pedophilia, and incest. Why not.