Medicalization of GI: Can Conflicts in Gender Identity (GI) Be Considered a Disease?
The following was brought to my attention today and is
extracted from the Obituary Column of the Baltimore Sun:
Dr. John Money, one of the nation's pre-eminent sex researchers who
pioneered the study of gender identity and helped establish Johns Hopkins as
the first hospital in the country to perform adult sex-change operations,
died [recently] He was 84.
His most memorable and criticized work was advocating sex-change operations
for patients confused over their gender, a position that was denounced by
some colleagues who favored counseling instead of surgery. In 1979, Hopkins
announced that it no longer would perform the operations.
For more on Dr. John Money from Wikipedia click here.
However, Money’s death brings up the ethical topic of the medicalization of gender. Do conflicts or uncertainties of gender identity represent a pathologic process, which requires medical treatment as a disease? To obtain more information about gender identity issues go to GIDinfo and specifically for the conflicting views of the medicalization of gender identity “disorder” click
here
When you are through reviewing the subject then come back and write your views here and also tell us specifically what arguments seem the most valid to you. If you already have knowledge about the conflicting views, go ahead and set yours down here but provide us with the basis for what you believe.. then we all will learn. …Maurice..
posted by Maurice Bernstein, M.D. @ 1:02:00 PM
4 comments
4 Comments:
I don't think we know enough about either the cause(s) or the nature of GID to say whether it is or isn't a true disorder or pathology.
The claim that it must be so recognized to legitmate the use of " psychological, endocrinological, or surgical services from the medical community" presupposes that medical knowledge and techniques cannot be legitmately applied for non-medical purposes. But that simply isn't the case, since such services are regulary provided in the service of cosmetic goals without a medical rationale, as well as for non-medically indicated control of reproduction.
The claim that recognition of GID as a bona fide pathology is necessary to secure insurance coverage for treatment, on the other hand, does ring true. But as an argument for viewing GID as a pathology, it seems to put the cart before the horse.
Dr. Bernstein ... I agree with Mr. Koepp. I've read and reread the information on the pages you provided links to, and I don't think that any of the arguments are completely right, or completely wrong.
There's not only too much missing information, I believe that there could possibly be almost as many different answers as there are individuals.
Have you formed an opinion about this subject?
I don't believe there is a simple answer here. For some GID people I know, the complete medical route was the only way they could function and I think that is the key thing here-what is best for enabling the person to function in society. I have seen the positive effects of transitioning on their lives.
Other GID people, maybe because they don't have the same degree of GID-I don't know- are reluctant to go the medical route. That after all really is an expensive option. So they are trading off avoiding the investment in hormones, plastic surgery including reassignment surgery, but still putting up with a society that's not overly understandng of people who don't fit binary gender roles.
The lack of detailed knowledge regarding the causes of gender identity conflicts is irrelevant, in my opinion. Medical practice is filled with examples of conditions that are treated despite the fact that we know little about the cause. Detailed knowledge about the underlying biological pathology has never been a necessary prerequisite for a condition to be regarded as pathological.
Suppose a patient came to a neurologist's office with the following symtoms:
Paralysis of the right arm and left leg.
Downbeating nystagmus in the right eye, and upbeating nystagmus in the left eye in darkness. In light, there is rightbeating nystagmus in the right eye and leftbeating nystagmus in the left eye. (Nystagmus refers to a particular type of uncontrollable, inappropriate eye movement.)
Now, I think it safe to say that there is no known medical condition that would lead to this pattern of symptoms. Would that stop the neurologist from doing his best to help the patient? Should it?
I think it safe to say that gender identity problems are caused by a brain abnormality of some sort. We may not know precisely what it is, but I believe that we should treat the patient as best we can. Currently, gender re-assignment surgery restores happiness to many such persons. It is, therefore, a reasonable medical solution to a condition that, frankly, is *OBVIOUSLY* a form of pathology.
Counselling would be a viable treatment only if scientific evidence existed to support its effectiveness in restoring happiness to persons experiencing this problem. No such evidence exists.
I honestly don't know what definition of pathology anyone could be using that would lead them to the conclusion that this is not a form of pathology.
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