I honestly do not want to be writing this article. As a clinical psychologist and pioneer in gender research and treatment, I would prefer to be discussing the current proliferation and social phenomenon of what is being called gender transition with my colleagues, attending conference presentations on the topic and reading research articles addressing the many levels and complexity of the issue.
But none of these things is happening. Instead, there is a deafening silence on the part of most individual psychologists and an enthusiastic, unquestioning and unresearched explosion of support for transgender motives, actions and people by others. I too want to offer support for human rights, but uninformed and unquestioning support may actually involve harm, so instead, I am asking for psychology to step up and take on its responsibilities in this regard. In this article, I will describe some of what I consider those responsibilities, along with some of the important questions that must be asked.
Not only the conferences, but the classroom and the laboratory are appropriate places to be asking important questions. Yet the inhabitants of these venues are being silenced in the name of human rights and a purported bias named “transphobia.” Academics have been censored and in some cases, lost their positions for just using language deemed unacceptable by the transgender movement, words such as “women.” Yes, “women” is considered hate speech and this purported transphobic hate speech is being aggressively monitored and eliminated in our very universities.
And make no mistake. Transgenderism has become a social movement and no longer only a personal preference or psychological issue. Those who even dare to question its validity, as I am doing here, are subject to threats, hatred and abuse in person and on social media. Professors have lost their jobs at some universities. Silencing any discussion in the universities is not to be ignored, but taken as a serious signal of danger to free speech.
You may have already read political and personal opinions about the issue of transitioning from one sex to the other. On the other hand, you may not have even been aware of the raging argument in some quarters until I raised it here. Either way and for those who occupy the midground, I want you to be informed about the role of psychology in this roiling cultural controversy.
It is destined to affect you personally if it has not already. You are bound to have a relative, a friend or a co-worker bring this issue from the abstract to the personal, as proclaimed gender defiers are inventing more and more genders rather than attempting to abolish this social construction, as did feminists before them. More perniciously, their wordplay includes substituting the term “gender” for the sex change that they are attempting. The reason for this substitution is simply that sex can not be changed. It is a biological reality rather than a socially constructed idea. Sex is currently immutable; gender is not. The conflation of these human characteristics can and does lead to confusion at best and irreversible physical damager at worst.
This formerly personal psychological issue, which affected only 0.1% of the population, has exploded into a social movement with all the characteristics of social contagion. In elementary and middle schools, groups of friends are transitioning together rather than joining a sorority or a fraternity. Girls and boys both are often beginning to discover that they are same-sex attracted. Girls, in particular, may be desperate to escape the dangers and strictures of being in a female body. Others just find it cutting edge cool and want to be part of the group or to defy their parents, as other generations accomplished by smoking, drinking and using drugs.
Psychology, in an important sense, resides in the territory between philosophy and psychiatry/medicine and also the “hard” sciences, striving to include a wide spectrum of epistemologies from the various psychotherapeutic practices to empirical laboratory research under its aegis. Yet even the “softest” practice of psychotherapy aspires to the gold standard, evidence-based practice. And yet…
This newly minted identity seems to have sprung full-blown from philosophers from Foucault to Butler. It is more difficult to ascertain how it took such a firm foothold in the popular imagination. I can guarantee one thing. Transgender people do not have the power or money to garner this attention without some powerful support. Why these often hidden founders and funders support this ideology is a question for another time, but a crucially important one. I will say this much. They are looking for huge social changes, not personal-psychological ones.
Philosophy is designed to analysis with ideas and conduct thought experiments. It is not held to a standard of empirical validity nor should it be, in my opinion. It is a form of intellectual exercise and play. Philosophy can define and opine, psychology must define and design valid and reproducible research. Before the ideas of philosophy are taken to have value for application, they must be tested in the realm of the empirical. Good questions must be formulated, hypotheses derived from them and repeatedly tested in the real world before we decide to place confidence in these novel ideas and to apply them in the real world of psychotherapeutic and medical practice.
The diagnostic of “gender dysphoria” actually came into existence as “gender identity disorder” and replaced the pathologizing of homosexuality (eliminated in 1973) in the DSM, the psychiatric bible. These diagnoses are adopted by popular vote of the American Psychiatric Association members, democratic rather than scientific. They have the strongest investment in construing psychology in terms of health and pathology. The association members had been convinced by lobbying groups and research, to vote to “normalize” homosexuality. In doing so, they wanted to leave a diagnostic possibility for those who remained conflicted about their sexual orientation. Diagnosis permits treatment via the official approval of the insurance companies, who today control the professions to a frightening extent. Thus was born “gender identity,” seemingly a harmless and even generous compromise.
Proponents of the transgender movement actually hijacked this diagnosis, along with the 50 years of feminist theory, practice and discoveries about the social construction and contextual nature of gender and spun them into a human rights movement, but not one for women. In fact, this movement actually infringes on many of the hard-won rights of women, including not only the right to assemble as a sex-based group but the right to call ourselves women, mothers and daughters. It even attempts to destroy the very concept of sex by conflating sex and gender, but make no mistake, lifetimes of research support unequivocally the difference between sex and gender. They may influence each other, but they are not the same thing. And sex can not be changed. It is a biological reality.
Perhaps the cruelest cut of all is to use our own half-century of feminist research and writing against us. These ideas are not an extension, but a perversion of feminist thought. The most radical goal of gender research, which has been only partially successful, has been to eliminate gendered categories and strictures rather than to multiply them. Feminists tend for obvious reasons to be social constructionists. But physical constructionists never. Feminists tend to respect and live in accord and peace, not try to dominate Mother Nature, not to outdo her or destroy her. We come in peace.
Here are some more important questions. If psychologists and psychiatrists are going to pathologize and diagnose, a questionable practice at best, then shouldn’t they diagnose carefully, as lives depend upon it? Are they then considering and eliminating such diagnoses as narcissism or sociopathic disorders, sexual fetishes, dissociative disorders or even delusional disorders? Is transitioning more like self-cutting or eating disorders than like homosexuality? Increasingly many patients are self-diagnosing, a practice not offered by the professions to any other group.
Here is another excellent epistemological question that we should be asking. Who decided to designate LGBT+ as a group, as the alphabet people? The T, in fact, has little besides this marginality in common with the LGB and, if anything it poses as a cure for homosexuality, more acceptable to many parents than having a gay child is. In countries such as Iran, homosexuals are compelled to change genders so that the country can rid itself of all homosexuality by a flick of the scalpel. Thus, you will see the government of Iran stating that there are no homosexuals in their country.
Medical/psychological treatment is reminiscent of earlier procedures endorsed by the professions such as trephining and lobotomies, as well as conversion therapies, all discredited today. These physical “cures” are decried as torture and, in my opinion, so will those of transitioning be by future generations. If people want to play with gender fluidity, why not leave them alone to do so rather than diagnose them? If they want to aspire to change their biological sex, why not ethically remind them that sex change within the human species is not possible?
The seeds of the next problem are contained in the current solution. I believe that, in the not-so-distant future, we are going to have numerous groups for adult survivors of gender transition, including those who are critically ill from the side effects of a lifetime of hormones, those who are sterile and those who have related regrets. Treating them may well be the future of a large segment of psychology.