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View Full Version : Gender re-assignment (split from Does God have a SOH)



Cat
11-05-2004, 08:19 PM
You would allow homosexual couples to adopt children but won't give juniors a rating bonus for growing hair in their groin.

The Yanks are in the process of producing a new raelity-TV show apparently, where 6 couples battle it out in front of the cameras to adopt a new baby. The baby is put up for adoption, then couples are invited to compete on rael TV for the prize of adoption. I don't know whether viewers votes will ultimately decide the outcome. A bit tricky if there's a split decision.

How about that appalling Australian decision about a young girl, brought up as a tom-boy, entering a gender re-assignment program at the age of 13?

Kevin Bonham
11-05-2004, 08:30 PM
How about that appalling Australian decision about a young girl, brought up as a tom-boy, entering a gender re-assignment program at the age of 13?

Why appalling? I'm open to being convinced either way on this one, it's an interesting situation, what have you got?

Cat
11-05-2004, 10:06 PM
Why appalling? I'm open to being convinced either way on this one, it's an interesting situation, what have you got?

Now I don't know whether you are deliberately caricaturing yourself here, or being completely niave. If this is a very clever witticism, then I'm pleased to see you've discovered your imagination at last. If this statement is sincere, then look back at the last few post Matt has made about your character - I shall look forward to seeing you being savaged by the wolves.

Kevin Bonham
12-05-2004, 12:25 AM
Now I don't know whether you are deliberately caricaturing yourself here, or being completely niave. If this is a very clever witticism, then I'm pleased to see you've discovered your imagination at last. If this statement is sincere, then look back at the last few post Matt has made about your character - I shall look forward to seeing you being savaged by the wolves.

This is uncalled for and 100% out of order - I wasn't even making a statement, just asking you to explain why you were appalled that a 13 year old was allowed to be involved in a process that will eventually lead to gender reassignment. Believe it or not I am actually interested to see what arguments you have about the matter. If I had a strong opinion about it, I would have stated it.

Cat
12-05-2004, 03:20 PM
Why appalling? I'm open to being convinced either way on this one, it's an interesting situation, what have you got?

Well on the face of it, one would say it seems an outrageously stupid decision. I must say I don't know all the facts in the case but I find it hard to imagine any scenario that could justify this kind of intervention that wasn't biologically determined - in other words unless there were genetic or biochemical reasons to justify the intervention. As I understand the case for intervention was made on sociological rather than biological grounds and this I find incredibly disturbing.

Bill Gletsos
12-05-2004, 03:33 PM
How about that appalling Australian decision about a young girl, brought up as a tom-boy, entering a gender re-assignment program at the age of 13?
As I understood it the child was brought up and treated completely like a boy and not as you so misleadingly put it a "tom-boy".

PHAT
12-05-2004, 03:42 PM
If I had a strong opinion about it, I would have stated it.

:eek: You cannot be human. :hand:

PHAT
12-05-2004, 03:49 PM
As I understood it the child was brought up and treated completely like a boy and not as you so misleadingly put it a "tom-boy".
What realy matters is if the structural anatomy of her brain is male or female. It is almost certainly female. Given a few years, that "side" will come to the fore and gender reassignment will not be appropriate. To do it now is one of the THE MOST DISGUSTING and STUPID medical actions I have ever heard of being canvased in a modern western society.

Bill Gletsos
12-05-2004, 03:55 PM
What realy matters is if the structural anatomy of her brain is male or female. It is almost certainly female. Given a few years, that "side" will come to the fore and gender reassignment will not be appropriate. To do it now is one of the THE MOST DISGUSTING and STUPID medical actions I have ever heard of being canvased in a modern western society.
Perhaps, perhaps not.
I would suggest the judge making the decision heard opinions from experts in the field both for and against. Experts I dare say with more credentials than you and the Doc.

PHAT
12-05-2004, 04:19 PM
Perhaps, perhaps not.
I would suggest the judge making the decision heard opinions from experts in the field both for and against. Experts I dare say with more credentials than you and the Doc.

I believe that the "experts" were not experts in neurobiology or physiology. They were psychologist - the profession that gave credance to Jung.

Cat
12-05-2004, 04:30 PM
Perhaps, perhaps not.
I would suggest the judge making the decision heard opinions from experts in the field both for and against. Experts I dare say with more credentials than you and the Doc.

I think they used the terms 'in her best interests'. The last time that sentiment was used was in relation to aboriginal children to justify removal from their primitive mothers.

This is a dangerous social experiment that demands a social opinion. None of us cannot ignore the consequences of this decision because it has potentially enormous social consequences for all of us.

The first question I would have is how a 13 year old girl knows anything about gender re-assignment. How did her charge or her medical attendants raise this subject. Most 15 year olds would know little about this area, let alone 13. And I do have some expertise in this area, I have been talking to 15 yr olds on the Gold Coast for some years in the classroom on issues of health relevant to their needs.

And what expertise precisely do judges possess in making these kinds of determinations. Some of the judgements and sentancing handed out over the years beggars belief. Anyone with any understanding of the court systems would have little confidence in the legal system possessing wisdom in this area.

But at the end of the day, what constitutes an acceptable decision depends very much on social opinion. Unless society registers its disgust at these kinds of judgements, then they will continue. It is our civic duty to demonstrate our outrage. :evil: :evil: :evil: :evil:

Kevin Bonham
12-05-2004, 07:01 PM
Having read a bit more about the case it's very tempting to strongly take the "for" side for the sake of argument just to watch Dave and Matt squirm in their attempts to knock it over. That said, I'm still keeping an open mind on this, though some of Dave and Matt's arguments look a bit dodgy. One thing that I have seen stressed is that the treatment (he? she?) will have before reaching age 18 is supposedly fully physically reversible, even so that should she change her mind and decide she wants to stay a woman, she will still be able to have children. I'm not sure whether that affects Matthew's concerns any and I realise that this doesn't say anything about the mental impacts.


I think they used the terms 'in her best interests'. The last time that sentiment was used was in relation to aboriginal children to justify removal from their primitive mothers.

I think there is a difference in consent from that case, even if the court has ruled she is not mature enough to give a legally sufficient consent.


The first question I would have is how a 13 year old girl knows anything about gender re-assignment. How did her charge or her medical attendants raise this subject. Most 15 year olds would know little about this area, let alone 13.

I have no doubt you are right. But most of your 15 year olds are not sociologically transgendered and hardly have the motive to become experts on sex changes. Is it really that hard to expect a 13 year old who feels strongly that they should be the other gender to start thinking and asking about whether their biological gender can be changed?


And what expertise precisely do judges possess in making these kinds of determinations. Some of the judgements and sentancing handed out over the years beggars belief.

Perhaps we should start a seperate thread for those. I have found that sometimes I've considered a sentence outrageous (usually too lenient) but then later been convinced that while the sentence in isolation was unjust, the (-)ve impacts of a harsher sentence would have been worse. At other times, I have remained unconvinced ... but all I've got by way of relevant skill is a backing in the cases for and against the philosophies of punishment used to justify those sentences.


Anyone with any understanding of the court systems would have little confidence in the legal system possessing wisdom in this area.

I gather that the court has to make a judgement based on what sense it can make of expert opinion under the law. I have followed court situations where expert opinions clashed and the court had to make a decision based on taking the most pessimistic estimate and acting cautiously. How do you act cautiously in a case like this though? There is no "precautionary" approach.

Kevin Bonham
12-05-2004, 07:06 PM
I believe that the "experts" were not experts in neurobiology or physiology. They were psychologist - the profession that gave credance to Jung.

Unusual to see you bashing psychologists - usually you're diagnosing almost everybody in sight with supposed mental disorders that didn't even "exist" until psychiatry discovered them. Still, I agree that neurology/physiology should have been in the mix (directly or indirectly) and I'm trying to find out who the consulted experts were.

I might even try finding a case transcript - would be fascinating reading.

Kevin Bonham
12-05-2004, 07:13 PM
Some background (mostly legal) on the case here (http://www.abc.net.au/rn/talks/8.30/lawrpt/stories/s1090024.htm) . It gives the impression that medical factors were considered, but it is not made clear how comprehensively or whether that evidence was taken from a direct or indirect source.

PHAT
12-05-2004, 07:28 PM
More info on this stupidity.

http://www.news24.com/News24/World/News/0,,2-10-1462_1512041,00.html

Cat
13-05-2004, 12:00 AM
[QUOTE=Kevin Bonham]Having read a bit more about the case it's very tempting to strongly take the "for" side for the sake of argument just to watch Dave and Matt squirm in their attempts to knock it over. That said, I'm still keeping an open mind on this, though some of Dave and Matt's arguments look a bit dodgy. One thing that I have seen stressed is that the treatment (he? she?) will have before reaching age 18 is supposedly fully physically reversible, even so that should she change her mind and decide she wants to stay a woman, she will still be able to have children. I'm not sure whether that affects Matthew's concerns any and I realise that this doesn't say anything about the mental impacts.

I really strive to be nice to you Kevin, but it is hard at times. Why don't you try to imagine how suppression of puberty and secondary sexual characteristics affects an individual - how it does it permenantly. Haven't we discussed at length how the sex hormones affect brain development in a child? How can a prepubertal child, who by definition is not yet experiencing any significant effect from the sex hormones, possibly understand anything about mature sexuality - enough to disrupt their natural biological development.

Many girls at this age resent sexual development, many want to remain in their prepubertal form. In essence anorexia nervosa is a reaction to this change in body form. What is happening th this girl may be extreme, but it is not unusual.

When life expectancy amongst indigenous peoples is as low as regions of West Africa, when a country countenances a level of health and disease within these communities most of us would consider insufferable, when the public hospitals, starved of cash, lurch from one crisis to another, when waiting times for essential operations are unacceptably long, to misuse health services in this way as the courts have done is nothing short of an outrage.



I think there is a difference in consent from that case, even if the court has ruled she is not mature enough to give a legally sufficient consent.

I was suggesting that the establishment has much experience in matters of great stupidity.

Rincewind
13-05-2004, 12:19 AM
In essence anorexia nervosa is a reaction to this change in body form.

I thought AN was more to do with unrealistic body image and also occurs too frequently in post-pubescent women to be "in essence...a reaction to change in body form" as a result of puberty. Although I admit said body form change can cause a body image problem. Calling this a reaction in terms of a desire (conscious or subconscious) to remain in the pre-pubescent body form, is (IMHO) an over simplification of the causes of the condition.

Bill Gletsos
13-05-2004, 12:27 AM
Whats Up Doc?
It seems you cant get you attempts at quoting done correctly.
You get it wrong more often than you get it right.

Hmm come to think of it that's true for most things. :whistle:

Cat
13-05-2004, 12:45 AM
I thought AN was more to do with unrealistic body image and also occurs too frequently in post-pubescent women to be "in essence...a reaction to change in body form" as a result of puberty. Although I admit said body form change can cause a body image problem. Calling this a reaction in terms of a desire (conscious or subconscious) to remain in the pre-pubescent body form, is (IMHO) an over simplification of the causes of the condition.

Anorexia Nervosa can occur at any time of life and the causes are multifactorial. More recently we are seeeing rising rates of anorexia nervosa in young boys, something previously considered unusual. The peak age for anorexia nervosa is during teenage years and yes it does relate to percieved body image. Many girls imagine the changes in body form associated with puberty to be grotesque and the purgative behaviour is a subconscious attempt to counter these changes. Of course home background plays the major role.
Many more girls resent their changing body shape but do not display pathological behaviour. As they become more feminine they grieve for their prepubertal state, climbing trees, rough & tumble etc. They dislike many of the restrictions increasing feminity imposes. This is a normal stage of development and eventually they obviously adjust and enjoy their new-found feminity in ways they could never have imagined!

Rincewind
13-05-2004, 01:24 AM
It is a over-simplification, but I would say the main "cause" of anorexia is the suffer perceiving themselves to be a different shape (usually fatter) then they objectively are. Why they develop this unrealistic body image is a complex question but I think it makes sense that society expectations weigh heavily on teenagers and the condition may be brought on by an overzealous desire to meet or exceed those expectations, rather than feelings of resentment of changing body form.

Alan Shore
13-05-2004, 01:36 AM
Anorexia Nervosa can occur at any time of life and the causes are multifactorial. More recently we are seeeing rising rates of anorexia nervosa in young boys, something previously considered unusual. The peak age for anorexia nervosa is during teenage years and yes it does relate to percieved body image. Many girls imagine the changes in body form associated with puberty to be grotesque and the purgative behaviour is a subconscious attempt to counter these changes. Of course home background plays the major role.
Many more girls resent their changing body shape but do not display pathological behaviour. As they become more feminine they grieve for their prepubertal state, climbing trees, rough & tumble etc. They dislike many of the restrictions increasing feminity imposes. This is a normal stage of development and eventually they obviously adjust and enjoy their new-found feminity in ways they could never have imagined!

And not just girls.. I think this works among both genders with the 'yearning for childhood once more'. I'd agree with Barry somewhat, the social pressures of maintaining a figure it much greater for a female however, moreso than this loss of adolescent identity - it simply correlates more consistently.

Kevin Bonham
13-05-2004, 01:51 AM
I really strive to be nice to you Kevin, but it is hard at times.

Please don't exert yourself on my behalf. A token effort would be fine. Save your energy for not misinterpreting what I'm saying (not that this was any more than a mild example).


Why don't you try to imagine how suppression of puberty and secondary sexual characteristics affects an individual - how it does it permenantly.

I can imagine all that, to the extent that my lack of specialist knowledge on the subject permits. But I can also imagine how psychologically traumatic it might be to be in a female body while more or less convinced you're a boy, and then to suddenly start going through full-blown puberty as a female (this point occurs at the bottom of the link posted by Matt).

So I wonder whether there is a serious risk of permanent harm of some kind whether the treatment goes ahead or not. What do you think the prognosis for this teenager would be if there was no change?

(NB I did make one mistake in my summary of the arguments I gave before. Some of the irreversible treatments start at an age described as "post 16", not necessarily post 18.)


Many girls at this age resent sexual development, many want to remain in their prepubertal form.

And would it be likely that that reaction would be far more extreme if the girl in question believed herself to be, and was only comfortable with being, a boy? This is apparently a child who has already felt suicidal over gender confusion issues even without puberty kicking in.


When life expectancy amongst indigenous peoples is as low as regions of West Africa, when a country countenances a level of health and disease within these communities most of us would consider insufferable, when the public hospitals, starved of cash, lurch from one crisis to another, when waiting times for essential operations are unacceptably long, to misuse health services in this way as the courts have done is nothing short of an outrage.

Firstly, do you know if it's going to be dealt with by the public health system or the private? (I gathered the former, but not certain.)

Secondly, is public health prioritisation a grounds on which the courts (in this case the Family Court) are permitted to rule on these things under law? It may be that your anger over priorities would be best directed at the parliaments that make the laws, not the courts that enforce them.

Thirdly, while I agree that all the things above are extremely important and in serious need of much better funding, saving 13 year olds from killing themselves is hardly to be dismissed out of hand either - if that is indeed what this accomplishes.

Cat
13-05-2004, 07:37 AM
It is a over-simplification, but I would say the main "cause" of anorexia is the suffer perceiving themselves to be a different shape (usually fatter) then they objectively are. Why they develop this unrealistic body image is a complex question but I think it makes sense that society expectations weigh heavily on teenagers and the condition may be brought on by an overzealous desire to meet or exceed those expectations, rather than feelings of resentment of changing body form.

Of course society pressure plays an enormous role, thats why we're seeing anorexia nervosa developing more & more in boys, there's no doubt about that. Remember anorexia nervosa is a spectrum of pathology, no a single entity. Aetiology can be quite different in different patients and so can disease manifestation, with bulimia being present for some but not others for example.

The effects of changing body shape in puberty and it's role in the development of anorexia has been well documented and few who work in this field would seriously contest this Barry. As I say, the causes are multifactorial, but the reason why anorexia is so prevalent in teenage years is understood to be linked to puberty.

Cat
13-05-2004, 07:50 AM
I can imagine all that, to the extent that my lack of specialist knowledge on the subject permits. But I can also imagine how psychologically traumatic it might be to be in a female body while more or less convinced you're a boy, and then to suddenly start going through full-blown puberty as a female (this point occurs at the bottom of the link posted by Matt).

So I wonder whether there is a serious risk of permanent harm of some kind whether the treatment goes ahead or not. What do you think the prognosis for this teenager would be if there was no change?


And would it be likely that that reaction would be far more extreme if the girl in question believed herself to be, and was only comfortable with being, a boy? This is apparently a child who has already felt suicidal over gender confusion issues even without puberty kicking in.



Firstly, do you know if it's going to be dealt with by the public health system or the private? (I gathered the former, but not certain.)

Secondly, is public health prioritisation a grounds on which the courts (in this case the Family Court) are permitted to rule on these things under law? It may be that your anger over priorities would be best directed at the parliaments that make the laws, not the courts that enforce them.

Thirdly, while I agree that all the things above are extremely important and in serious need of much better funding, saving 13 year olds from killing themselves is hardly to be dismissed out of hand either - if that is indeed what this accomplishes.

Well the conventional approach to treatment of depression and suicidal ideation is through management of their depression. Depression is actually a contra-indication to gender-reassignment, in that an individuals thought processes are disrupted and not only is decision-making difficult, but often when the depression is relieved the thought processes and feelings of the individual are quite different.

Depression is a biochemical disease of the brain associated with low serotonin levels in the synapse. As such it is no different to diabetes (say) which is a biochemical disease of the pancreas and should be treated not with sex hormones (generally) but with appropriate medication viz. anti-depressants.

The outcomes of gender-reassignment procedures performed in adults with ongoing psychological problems are dreadful, and as I say are not done because the procedure is contra-indicated. Even in healthy adults the outcomes are sometimes very bad. Overall the effectiveness of the treatment must be considered poor.

Rincewind
13-05-2004, 01:45 PM
The effects of changing body shape in puberty and it's role in the development of anorexia has been well documented and few who work in this field would seriously contest this Barry. As I say, the causes are multifactorial, but the reason why anorexia is so prevalent in teenage years is understood to be linked to puberty.

I'm not denying a link to puberty at all. But as to whether the condition is caused by feelings of resentment of changing body form. It is more consistent with what I read that social pressure causes the body image problem which leads to anorexia which can also lead to feelings of resentment regarding the changes of body form associated with puberty, not the otherway round.

Cat
13-05-2004, 02:16 PM
I'm not denying a link to puberty at all. But as to whether the condition is caused by feelings of resentment of changing body form. It is more consistent with what I read that social pressure causes the body image problem which leads to anorexia which can also lead to feelings of resentment regarding the changes of body form associated with puberty, not the otherway round.

Of course, both of these situations exist. Remember many societies hold the more voluptous forms in high regard and anorexia is prevalent in these societies also. Ill-Health is not as mechanistic as you seem to think, there are many possible causes and reasons for illness, not all co-existent necessarily. Don't believe everything you read in the Woman's Day Barry.

Rincewind
13-05-2004, 02:58 PM
Of course, both of these situations exist. Remember many societies hold the more voluptous forms in high regard and anorexia is prevalent in these societies also. Ill-Health is not as mechanistic as you seem to think, there are many possible causes and reasons for illness, not all co-existent necessarily. Don't believe everything you read in the Woman's Day Barry.

As the only thing I read in the Woman's Day is the crossword, I'm sure that won't be a problem. As for the source of my info, my wife has a psychology degree and did work as a research assistant for Dr Gail Huon (now Assoc Prof at UNSW) in the area of eating disorders.

Cat
13-05-2004, 05:28 PM
As the only thing I read in the Woman's Day is the crossword, I'm sure that won't be a problem. As for the source of my info, my wife has a psychology degree and did work as a research assistant for Dr Gail Huon (now Assoc Prof at UNSW) in the area of eating disorders.

Well she should be able to clear up any areas of uncertainty for you Barry.

Rincewind
13-05-2004, 06:00 PM
Well she should be able to clear up any areas of uncertainty for you Barry.

No doubt should any come to light. I was just rebutting your inference that my position was based on articles I'd read in the Woman's Day.

Kevin Bonham
13-05-2004, 07:27 PM
That's more like it. David, I'm puzzled that you didn't say all that stuff much earlier - the easiest way to try to demolish an excessive proposal is often to point out a simpler alternative. Maybe you were hoping I'd get carried away with the rather unconvincing nature of your earlier arguments and make a silly mistake? :eek:


Well the conventional approach to treatment of depression and suicidal ideation is through management of their depression. Depression is actually a contra-indication to gender-reassignment, in that an individuals thought processes are disrupted and not only is decision-making difficult, but often when the depression is relieved the thought processes and feelings of the individual are quite different.

So you'd slug her full of happy-drugs (sorry, cliche there) and hope that under that influence she decided that being a girl wasn't so bad after all despite all the indications given by her upbringing? Actually I haven't even seen that alternative mentioned in the links posted above at all - it would be extremely useful to know whether this was considered by the court, if not why not, if so why it wasn't preferred. If I knew that, eg through reading the transcripts, it would probably swing my irrelevant opinion of the entire case. But I suppose with Family Court the transcripts would be confidential.

I'm not at all assuming the court was infallible in all this. Courts do make mistakes in handling expert evidence, or sometimes they are forced into an incorrect handling of expert evidence by legislative barriers or mistakes by lawyers. For instance I followed one ecological case here that was resolved incorrectly because one lawyer failed to establish his witness's expertise broadly enough, not realising that the opposing expert witness would successfully claim expertise in an unexpected area.


Depression is a biochemical disease of the brain associated with low serotonin levels in the synapse. As such it is no different to diabetes (say) which is a biochemical disease of the pancreas and should be treated not with sex hormones (generally) but with appropriate medication viz. anti-depressants.

Is it true that some people are essentially disposed to being depressed while others may only become depressed temporarily in sufficiently adverse situations? If so, does simply addressing the external "cause" of the depression work in the latter situation?

Cat
13-05-2004, 08:59 PM
[QUOTE=Kevin Bonham]That's more like it. David, I'm puzzled that you didn't say all that stuff much earlier - the easiest way to try to demolish an excessive proposal is often to point out a simpler alternative. Maybe you were hoping I'd get carried away with the rather unconvincing nature of your earlier arguments and make a silly mistake? :eek:



So you'd slug her full of happy-drugs (sorry, cliche there) and hope that under that influence she decided that being a girl wasn't so bad after all despite all the indications given by her upbringing? Actually I haven't even seen that alternative mentioned in the links posted above at all - it would be extremely useful to know whether this was considered by the court, if not why not, if so why it wasn't preferred. If I knew that, eg through reading the transcripts, it would probably swing my irrelevant opinion of the entire case. But I suppose with Family Court the transcripts would be confidential.

I'm not at all assuming the court was infallible in all this. Courts do make mistakes in handling expert evidence, or sometimes they are forced into an incorrect handling of expert evidence by legislative barriers or mistakes by lawyers. For instance I followed one ecological case here that was resolved incorrectly because one lawyer failed to establish his witness's expertise broadly enough, not realising that the opposing expert witness would successfully claim expertise in an unexpected area.

As you say it is difficult to make judgements without full knowledge of the facts and my reticence was to do with professional courtesy and respect of the child's interests in not becoming an issue of public discussion. Having said that it is a subject of social importance. Quite simply it is hard to envisage any circumstances where I or any of my colleagues would opt for the kind of management plan described in the popular media. We are often faced with extreme situations, so that in itself is not justification for a therapeutic program that appears extremely unconventional to say the least.


Is it true that some people are essentially disposed to being depressed while others may only become depressed temporarily in sufficiently adverse situations? If so, does simply addressing the external "cause" of the depression work in the latter situation?

The terms are endogenous and exogenous depression, though in reality a spectrum exist. Exogenous depression is generally more amenable to drug therapy and responds very well. Endogenous depression often has a genetic basis and outcomes are not as good. The best outcomes in both conditions are achieved through a combination of medication and counselling.

Kevin Bonham
13-05-2004, 10:12 PM
As you say it is difficult to make judgements without full knowledge of the facts and my reticence was to do with professional courtesy and respect of the child's interests in not becoming an issue of public discussion.

... which is most amusing when you were the one who first mentioned the case in question here. :doh:

Apart from that, thanks for the expert comments.

PHAT
13-05-2004, 10:52 PM
An interesting thesis for anorexia

http://search.abc.net.au/search/cache.cgi?collection=abconline&doc=http/www.abc.net.au/rn/talks/8.30/helthrpt/stories/s883176.htm

Rincewind
14-05-2004, 12:12 AM
An interesting thesis for anorexia

http://search.abc.net.au/search/cache.cgi?collection=abconline&doc=http/www.abc.net.au/rn/talks/8.30/helthrpt/stories/s883176.htm

Good reading. Regarding the development of the brain in adolesence there was a short piece in Time last week. It wasn't up to the same standard as the Woman's Day but was interesting reading.

Oepty
14-05-2004, 10:55 AM
I haven't read much on this case, but it appears to me there are ways the situation that has happened could happen.
1. The girl was depressed and thinks that becoming a boy would solve her depression. ie the depression occured first
2. The girl thinks she should be a boy therefore became depressed about being a girl. ie the desire to change her sex came first

Has it been proven which came first. I would think the way to treat the problem would vary considerably depending on which of the above options is true.

My gut reaction is that all sex change operations are wrong but I have no real knowledge of the area so I am open to persausion these are required in some cases of unclear sex determination.

Scott

PHAT
14-05-2004, 02:34 PM
Unusual to see you bashing psychologists ...

Do you know any profession that does not deserve a bashing over something? :lol:

PHAT
14-05-2004, 02:46 PM
Well the conventional approach to treatment of depression and suicidal ideation is through management of their depression. Depression is actually a contra-indication to gender-reassignment, in that an individuals thought processes are disrupted and not only is decision-making difficult, but often when the depression is relieved the thought processes and feelings of the individual are quite different.

Depression is a biochemical disease of the brain associated with low serotonin levels in the synapse. As such it is no different to diabetes (say) which is a biochemical disease of the pancreas and should be treated not with sex hormones (generally) but with appropriate medication viz. anti-depressants.

The outcomes of gender-reassignment procedures performed in adults with ongoing psychological problems are dreadful, and as I say are not done because the procedure is contra-indicated. Even in healthy adults the outcomes are sometimes very bad. Overall the effectiveness of the treatment must be considered poor.

Great post. Spot on.