What people say
WGC SOC
DSM-V revision & Gendercare
More
That is a dialogue between Dr.Torres and a friend named L...
Hi L.....
See below please, my comments dear!
Thank you.
----- Original Message -----
From: L....
To: Torrwad
Sent: Thursday, April 02, 2009 3:52 PM
Subject: Re:
Thank you so much for this. I like the concept of UGC. And I readily see that as some classes of individuals may, in fact, have "true" Gender Identity Disorder, this allows room for those of us who don't. We all don't have to be classified as disordered to be who we are!!
Yes dear.
I don't see a difference, however, in the paternalistic system that a PGT or therapist needs to produce an approval letter.
We may not be sure, "a priori", who is living an UGC only, who is living an extreme UGC, and who has a real GID.
So we necessarily need to have a diagnosis (I prefer recognition) method - before anyone may start changing the own body.
So we defined an expertise - professional gender therapist (PGT) to be qualified to do that recognition job. See that this is a RECOGNITION ONLY - as an X-ray - the bone is broken or not? Need this bone a surgery or not?
That is a necessary step but may be done through a fast and unexpensive service - as we do today. Obviously would be great if governments could adopt that fast and unexpensive way - it would be easy to provide to the full country - and countries! free of charge for all citizens that require it!
Those who are diagnosed as UGC, without GID, should not have to adhere to this requirement, because they are not mentally incapable of making their own health decisions. They should be given a proposed treatment plan with timetables and such that they can self administer, or not, as they choose.
After the complete recognition (diagnose), I absolutely agree with you.
From then on the PGT - due to its experience - may help and bypass steps to loose less time and money for the client - IF THE CLIENT DECIDES THAT WAY.
But for hormonizations endocrinologic control is needed surely - and for surgeries a readiness letter also is needed for the protection of the surgeon.
So, when we talk about letters and follow up - they are not PSYCHOLOGIC OR PSYCHIATRICAL SLAVERY, surely.
It is a necessary treatment that in a world of patient centered informed consent should be purely the decision of the patient, with no professional interference!
Yes, I agree!
The one thing I notice that is different and refreshing is that you are talking gender only and not making the same mistake that WPATH and the DSM has made in mixing in sexual orientation. It is a major step forward to get rid of the ideas that Trans people are "gay men", or autogynephilic, or influenced solely by their sexual orientation to determine their true gender. It simply doesn't work that way. Both of these bankrupt theories rely on the idea that sexual orientation affect gender rather than the other way around.
Yes, we agree!
The first half seems to be more of a treatise on a new system to replace the current system of diagnosis. (DSM-IV) It seems to be addressing the means to diagnose, in a new way, the relative status of an individual within society and their unique difference in the population pool of all gender perception (including "common" gender identification). It also, incorporates the concept that the "binary" designations of only male and female are not the only possibilities. That is wonderful!!
Yes, that is the point! And that is not OUR OPINION only - but we have enough scientic evidence to show we can follow that way!
The rest flows well, is well defined, but still appears to have some of the paternalistic aspects that drive us nuts. "Approval letters" are still in evidence, and, although, you suggest that these need to be "administered" in a patient centered manner, in practicality, it won't be.
No dear, the patient will define each way ze (she or he, or ze) will really follow.
But a surgeon need a letter to performa a body change - a sex change - to dilute its responsibility. And the same the endocrinologist - so these two letters only really will be cented on the desire of the patient - after complete "diagnosis" - really recognition by an expert.
Currently, endocrinologists mostly rely on a letter from a therapist approving HRT. This drives most of us into unofficial networks and self administration. ( It did for me). Your point of control is not the PGT or the therapist, it is the endocrinologist and the surgeon, and, in the United States, the largest market of patients wanting this corrective medical treatments, it is often the insurance company.
Yes, we will need to fight this insurance company control that prevails nowadays - we will need to fight to change it. But now we have good evidences to change it.
We have not desires and opinions - but scientific knowledge.
All this "pushes back" on the therapeutic setting creating oppression that is probably not wanted by any therapist, but they cannot avoid, currently. This inevitably means either the patients insurance, or the doctors malpractice insurance, uses any excuse to block or slow down treatments to allow only those who need it the worst, or have the persistence to fight until they get it.
Yes, but the PGT will not be a gatekeeper only - he will only recognise and counsel - and suggest hormones and surgeries - WITH the patient and not AGAINST the patient as happens today.
While I readily admit, this may be another societal factor that really should not be the consideration of SOC, we, in the Trans communities are still stigmatized and traumatized by this socio-political environment just as much as the current DSM and WPATH systems of care, or lack there of.
That will need more time to change dear, but our effort follows that goal!
I don't pretend to have the slightest idea of how you can write this so that UGC and GID are treated differently in this paternalism.
I hope now I already explained - but if not, write me more details!
Those with UGC should not have to go through the paternalistic control of treatment protocol if they choose. A diagnosis of UGC should be a cleansing ratification that the person involved is not subject to the treatments that a diagnosis of GID may get. The problem with the current SOC is that it is used to define all of us who are UGC as GID. And this is punitive and brutal. I think you have realized this.
Yes, that was our first goal. Hip, hip, hurrah!
But, the change in therapy will become that, currently, we all try to manipulate the system to say and do whatever the therapist requires, which may include lying and deception, and with this SOC we will try to maneuver your diagnosis toward the UGC rather than a diagnosis of GID, with all its paternalism.
Our diagnosis is not subjective - no one will be able to manipulate it easily. We have 7 years of experience now and we may say that.
Obviously nothing is perfect - but to manipulate it will need some difficulties. No one will need to have TO FOLLOW THE DESIRES of a therapist. If someone try to manipulate we will see, and the recognition will be worse for the client - because all manipulation will be ALWAYS IN THE WRONG WAY.
The politics of control drive the current system, but you have not fully eliminated this as yet, or reduced it sufficiently, in my opinion.
L...., no one is absolutely free to do any body change, without experise or control.
That is not the good way.
The good way is to RECOGNIZE BEFORE any body change.
Than CHANGE THE BODY with the cooperation between the CLIENT, PGT and endocrinologist.
Then with the cooperation of the surgeon - the SRS and completion of all process - when desired.
Can you provide your hormones? And have a tromboflebitis, an AVC or trombosis? Heart attacks? Liver cancer, etc??? Without control?
No one is an island - we live in society and we need the help of others.
Can you do your own surgery?
No, you NEED the HELP FROM OTHERS.
They will help you - but you will need also to help them - even to help you.
What I agree with you - and is clear in my suggestion is - no patologization for what is not patological. And never a slavery - when you may participate considering decisions about your own life.
Maybe a review of your SOC in light of this element of control of the lives of others may give you some ideas. I will read it again in a couple of days and see if I can suggest anything.
Great! Thank you. As I read it some cents of times I may not see nothing better - but you may suggest us new points of view, for each step - and we will see!
Perhaps a clearer demarcation between UGC and GID can be delineated to provide this.
Hummm... I believe that will not be so easy, but I accept suggestions!
Any ideas on how to implement this?? Certainly, the current WPATH folks will dispute, and we can expect nothing but trouble from Zucker, et al, because they won't see that they are still in considerable control, but they will have to loose their grip on all of us who are UGC. And, most of all, they will have to deal with gender alone without being able to mix it into some distorted hybrid of both sexual oreintation and gender, which it is not.
I believe that change of perspective is a question of time - dialectics needs time.
After the fall of John Money - soon Zucker, Bailey and Blanchard, etc will follow the same way. All pseudoscience will follow the same way - always. That is a question of time - but we may increase the velocity - the way we are trying now - to accelerate the dialectic process for changing points of principle.
You, my dear friend, seem to be well on your way with this. Bon chance!!!!!
L..... S.....
Chair of Minn G A
Thank you L.....!
We are at the same side, against the same adversaries - and our adversaries are bad ideas, pseudocience and ideological manipulations - and not persons!
Wal
Gendercare
