Self-Organizing Man

[Update: I've edit the HTML on this post to make the presentation better. My apologies to Deborah Rudacille!]

I am pleased to recommend Deborah Rudacille’s The Riddle of Gender: Science, Activism and Transgender Rights. Her book can be filed under the What Is, Is category.

A writer of immense talent she owns her assumptions and perspectives, bringing her expertise as a science journalist to the topics of transsexual rights, activism and science.

In 2001 Deborah approached me at the True Spirit Conference and asked to meet with me. She had heard me give a keynote speech where I encouraged everyone in attendance to follow their creative voices. Deborah’s latest book, The Scalpel and The Butterfly had been recently published, and she was considering a book about transgender and transsexual communities. As a non-trans person she felt that perhaps she should not write such a book.

“Write it anyway,” I probably said. I probably told her that we needed to hear from all voices about trans communities. Her opinion and observations were as valid as trans peoples.

Then she left and I went on my way.

In March of 2005 I happened to see The Riddle of Gender on display at my local independent bookseller. Within the same week, after I sent her my blog address, Deborah and I had exchanged delightful emails . I asked, and she agreed, to be interviewed for this blog.

Throughout The Riddle of Gender, Deborah asks why transsexuals are increasing in numbers. Her agenda is clear. “Without denying the influence of social factors in helping more people come out, as a science writer I can’t help being interested in biological explanations for what seems to be a pronounced increase in the number of gender-varient people in the world today.” (page 16).

She then leads us through a transsexual history I knew very little about, including:

• Magnus Hirshfield’s (founder of Berlin’s Institute for Sexual Science) successful efforts to ease the pain felt by intermediates (transsexuals) through surgery (beginning in the 1900s through the late 1930s).
• John Money’s absolute failure to induce gender change using a social construction model only.
• An extensive discussion about an emerging group of scientists and lay people who believe chemicals released in the environment as well as drugs like DES, all of which disturb the development of the endrocrine system, may explain the increase of gender varient people.

Of particular interest to transsexuals, I think, is “Childhood, Interrupted.” Here Deborah Rudacille is a pioneer. One of the first, main-stream, non-trans people to provide persuasive, scientifically based evidence that GID (gender identity disorder), as defined in the DSM IV, does more harm than good.

“First, the designation of GID as a mental health problem does provide, and has provided, a license for stigmatization, and has undoubtedly contributed to the difficulty that gender-varient people have encountered in passing legislation protecting their civil rights…..

Second, the diagnosis of gender identity disorder does not facilitate insurance coverage of medical or surgical procedures for people desiring hormonal or surgical treatment; it does not guarantee coverage of anything other than mental health treatment by a psychiatrist or psychologist….

Finally, rather than “generating research” or research funding, the classification of GID as a mental disorder seems instead to have limited the research done on physiological mechanisms for gender varience, or on the intriguing connections between GID (gender identity disorder) and prenatal exposure to DES (diethylstilbestrol, a synthetic estrogen developed in 1938 and given to thousands of women between 1945 and 1970, in the mistaken belief that it would help prevent miscarriages) and other exogenous estrogens and androgens.” (pgs. 211-212)

Rudacille provides numerous examples of data that support reclassifying transsexualism from a psychiatric to an endocrinologocial condition.

Hallelujah!

I learned more reading Deborah’s book than any previous book about trans activism or history, bar none. She also includes wonderful interviews with a variety of trans people, some of them known to me, others knew. I found I identified with each of them. Another wonderful gift.

Get this book, read it and pass it on to your friends, family and loved ones.

One more thing about Deborah’s book. While I have never believed I had a psychiatric disorder I have wondered into the long night why I am the way I am. Her book has helped me understand my needs better. In a very direct way, The Riddle of Gender brought me a relief I did not know I was seeking.

Thank you, Deborah! You are shining example of what results when good science meets great compassion.

JS: Let’s talk about natural. Often transsexuality is questioned as unnatural. Yet the push to isolate testosterone and estrogen, eloquently described in your book, is never questioned as unnatural.

With transsexuals we see an intertwining of the natural results of science making the unnatural lives of transsexuals better.

This relationship fascinates me. We never question humans desire to exploit and understand our environment. But culturally we draw lines, ever moving and receding, about how that science will be applied and with whom. For instance, you mention concerns about plastic surgery apparent in fin de siecle as it played into people’s fears about Jews getting nose jobs and passing as Christians. . Nowadays nobody cares about nose jobs or Jews passing as Gentiles.

It has only been since my top surgery and hysto that I have come to appreciate what science and technology have done for me. And as I have shared with you, I believe we are the pioneers of said science and technology creating new human beings. I am an improvement, or at the very least, a new variation on the human experience.

Thoughts?

DR: Well, as a science writer I tend to have rather positive feelings about biomedical science and technology as forces that improve our lives in general, not just in this one particular area. While I was researching and writing my first book, THE SCALPEL AND THE BUTTERFLY: The War Between Animal Research and Animal Protection, it became quite clear to me that experimental science and medicine have vastly improved our quality of life (and increased the duration of our lives)in many ways. Does the fact that women aren’t forced to bear children from menarche to menopause and then losing half of them to infectious diseases before their 10th birthday qualify as “creating new human beings”? In some ways, I think it does.

Transsexualism is a special case in that permits a category of people who have apparently always existed (the neurologically intersexed) to modify their anatomy in order to create a better match between the sex of their brains and the sex of their bodies. At least, that’s the way that I view it, though I understand that others may see things differently.
I’m not sure that qualifies as making one “a new human being” or even a new kind of human being in a way that differs from the example I used above. Because people have been “changing sex” for centuries*socially, if not physically. It’s just that now the process is a lot more thorough!

Science and technology give us better tools to do the kinds of things we have always wanted to do.
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JS: Your chapter “Childhood, Interrupted” discusses the use and abuse of GID.

I particulary like how you describe the need for a diagnosis so that we can receive insurance reimbursement but write that the current DSM classification is outdated and bigoted. (Also Kit Rachlin’s [long time therapist, ally and advocate of the trans communities] comments about outcome studies for people who do not use the Standards of Care are very important, particulary for people who want insurance coverage and aren’t going all the way.)

If it were up to you, and you alone, describe some of the ethical dilemmas apparent in allowing people under the age of eighteen to change genders. With these emerging technologies, particularly the likelihood that our children will be able to enhance their bodies at a genetic level, who gets to decide? It seems to be the last place I would want to place that responsibility is with parents, or at least with them alone.

Too, our modes of socialization * families and schools * seem ill-equipped to handle these lightening fast changes in science. And certainly our legal system can barely handle copyrights and the internet. How can we expect the legal system to address these issues? (as an aside, I’ve visited a few futurist blogs that discuss genetic enhancement scenarios*and they seem to not know about transsexuals [one wrote that feminism didn't change boys into girls and girls into boys and I thought, forget feminism, technology did! But they write in a vacuum as though it has never occurred to them that people are already engaging in biological enhancement with biological broadly defined])

DR: Yes, I think it’s true that the people who are discussing genetic enhancement are pretty ignorant about transsexualism and its relevance to this discussion*in part because of exactly the issue that you raise, the DSM classification. It is very difficult for many people (even those who should no better, like physicians) to move beyond the old “sex change=mental illness” paradigm. It’s so deeply ingrained! So we have a lot of work ahead of us to change that.

That work has to proceed on a couple of levels, I think. We need to educate the public, but we also need to educate the scientists and physicians. This is particularly true when dealing with issues related to trans youth. Clearly, we don’t want kids being ostracized, stigmatized, therapized because of gender variance. If a child seeks out therapy to help come to terms with his or her identity, that’s one thing. But when a child is coerced into a therapeutic relationship in order to force the child to conform to gender norms, that’s something else again!

I think that the most perplexing conundrum confronting the trans community or communities and its allies these days is creating a new vocabulary and a new diagnosis which will facilitate things like insurance coverage, while not stigmatizing or pathologizing trans people. In my view, the best way to accomplish that task would be to support a reclassification of gid (by another name) from a psychiatric to a medical diagnosis. To recognize it as a form of intersex, basically. All the data is pointing in that direction, anyway, and I suspect that it will happen sometime in the next decade, though not without a certain amount of controversy and conflict.
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JS: Will the need we have to find biological reasons for variable behavior always be with us? In my case, the need people have had to be gatekeepers over a very natural human phenomenon is utterly ridiculous and thoroughly unimaginative!

DR: Well, as Christine Wheeler pointed out to me, “In medicine, something needs to be wrong in order to be fixed.” Now, that may not be true for certain kinds of cosmetic surgery, but then again those forms of cosmetic surgery tend not to be covered by insurance. And are also viewed as quite frivolous.

I think the urge or need to find biological explanations for behavior will certainly always be with us. After all, it’s one of the core reasons people do science at all*to find out “why” something happens. The other important question, of course, is “how.” So I think it’s interesting and important in general to know why some trans people are perfectly comfortable with the bodies they are born with, while others feel so acutely miserable that they will self-mutilate if denied surgery. And how physicians can help the latter group, especially if they are (as you indicated in your previous question) children or adolescents. It’s hard to know how to proceed if you don’t have data.

The question of “gatekeepers” is something else entirely since the gatekeepers are psychotherapists. Again, a consequence of GID being classified as a psychiatric, rather than a medical, condition.
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JS: EDCs (endrocrine disrupting chemicals) are one area where trans activists (some) are beginning to focus attention on the whys of why we are trans. . Your final chapter focuses on DES sons and the effects of EDCs on testosterone based life forms. What about estrogen-based life forms?

DR: I’m not quite sure what you mean by “estrogen-based life forms.” Human beings are actually estrogen-based life forms in some sense, and the estrogen receptor has been conserved across species throughout evolution. Both males and females manufacture estrogen, and in fact testosterone is converted into estrogen in the brain by an enzyme called aromatase. Estrogen is critically important in a number of body processes, not just reproduction*and again, that’s true for both males and females.

Possibly, you are asking what the effects of endocrine disrupting chemicals are on natal women, who produce such an abundance of endogenous estrogen throughout their lives? Well, some of the research has examined possible links between EDCs and high rates of breast cancer. Also between EDCs and accelerated puberty. Girls are reaching puberty much earlier these days and while we don’t know exactly why many have speculated that it’s the result of exposure to estrogens in diet and the environment.

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JS: What most pleased you about this book?

DR: I am most pleased by the positive reception the book has been getting from people who are in a position to know whether or not I did a good job. In other words, by people in the trans community, the larger LGBT community, and finally (for the science) the scientists themselves. When people in the community come up to me and say, “thank you for writing this book” it makes me really happy.

JS: What did you like the least?

DR: When I first began researching the book, I was very disheartened to discover the internecine warfare within the trans community and also within the larger LGBT community. From the outside, it looks like such a solid cohesive community, all embracing and rainbow flags flying and all that. But then, once you get inside you realize that there are some pretty violent disputes, both historical and contemporary.

I think this is true to an extent within all activist communities. But for some reason, I was shocked to discover it in this one.

JS: Why is transgender on the cover instead of transsexual?

DR: Because transgender is the umbrella category. I didn’t want to talk about just transsexuals*people who transform themselves through hormones and surgery*but also about people who choose not to alter their bodies in any way. People who are in any way gender variant. Which includes most of us, I guess, even those who consider ourselves normatively gendered. That’s one of the points I try to make in the book. Our concepts of gender are still evolving; the way we express gender is still evolving. It’s a very individual thing, which is at the same time biologically and culturally influenced.
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