Mercedes,
I'll pass this onto the Board of TAVA and we will probably respond to this. It will severely impact our efforts to help transgender veterans get fair treatment in the VA. Thank you for the E-mail and this posting.

Great post, Mercedes (as usual). Thanks for the heads up.

I hope the lesser known people on the list are that way because they're fair-minded....

My analysis is as follows:

The Chair, Kenneth Zucker is best known for his "Reparative Therapy" to "cure" homosexuality, and for similar practices to make TS children gay instead.

Jack Drescher, also on the panel, is best known for his labelling of Reparative Therapy as Junk Science practiced only by Quacks. See
http://au.youtube.com/watch?v=Kh6v9aysfQI

Ray Blanchard - again, a member of Jurassic Clarke like Zucker. His Freudian views on Transsexuality are that it is a paraphilia, "autogynaphilia" due to upbringing.

Peggy T. Cohen-Kettenis is a specialist on Neuroanatomy, and the difference between male and female brains, including transsexuals. She's done some good science.

Heino F. L. Meyer-Bahlburg is an endocrinological specialist, who knows a lot about the role of pre-natal hormones on gender development, and is the only one who has knowledge about Intersex conditions.

Of the rest, none have any specialised knowledge about Gender.

Niklas Långström specialises in violent male sex offenders
Irving M Binik specialises in female orgasmic disorders
Robert Taylor Segraves specialises in sexual dysfunctions, impotence etc
Cynthia Graham specialises in sex therapy with respect to contraceptive use
Richard B. Krueger again specialises in sex offenders

In summary: some of the most fringe workers in the field are now in charge. There appears to have been no input from the World Professional Association for Transgender Health. Both Intersex and Transsexual advocacy groups are horrified by this turn of events.

Some follow-up information:

I've sent an email to Dr. Douglas Haldeman, who is on the Board of Directors for the APA and has been their point of consultation on GLBT issues. In the past, and under his recommendation, the APA has opposed reparative therapies ( http://psychology.ucdavis.edu/rainbow/html/resolution97_text.html ) and clearly stated the harmful effects of such "conversion" treatment ( http://psychology.ucdavis.edu/rainbow/html/facts_changing.html ). Dr. Zucker's usage of "ex-gay" methods to treat children -- as well as his and Blanchard's continued defiance of the standards of care set out by WPATH should be effective points of concern for the APA, there.

Nerissa was also kind enough to forward the information on to a Board Member of the Gay and Lesbian Medical Association (GLMA was involved in the discussions that had "homosexuality" delisted as a "mental illness" in the early 1970s), who is a mental health expert working for the US Dept. of Health and Human Services.

I suspect that the APA was primarily ill-informed about Dr. Zucker and company, and hope that this can be overturned in short order, before damage can be done.

By the looks of all the cross posts and comments going around, you've lit the fire, I can only hope it blazes hot enough for the APA to feel and react accordingly.

3 quick comments:

1. Horrified but not surprised about CAMH stooges... ummm.. doctors, on the "task force"

2. Harry Benjamin did NOT write the original SOCs or any version of them. A protege and commitee (board) developed SOCs based on Benjamin's research, but he was not part of it. Huge difference to those of us who have been dealing with both professional and personal aspects of SOCs (and GID) for 20+ years.

3. WPATH has no authority to dictate SOCs or anything else. HBIGDA has been used as a crutch by treating professionals, WPATH has made it easier to get letters for those who might not really want to transition. Regardless of your opinion of either, SOCs have never had official authority just implied acceptance for whomever needed them for whatever reason. Mecedes needs to do research before fanning flames. Readers need to check those facts before swallowing everything they read in an internet blog. The facts are bad enough without dirtying the water with poop and drinking it.

Kind of makes me glad I finished transition when I did.

It looks like we are about to go back into the dark ages once again, in respect to how the medical community treats transgendered people. I had thought that the stink raised about Baily's book would have discredited him enough that the APA would see that the man is full of it.

Talk about stacking the deck.

Neither Zucker nor Blanchard are medical doctors, "doctors" in the usual sense, only PhDs.

What I find most disturbing is the mixing and matching of those who previously were simply diagnosed as transsexual and now somehow are being labeled as a sub-set under that transgender masking non-biological social construct.
I was a patient of Dr Benjamin and know that his professional attitude as a medical practitioner was not in compliance with those who pander or advocate for the transgender model of identity. Transvestites were to grow into transgender as an identity. That is what and how it was proposed by Charles 'Virgina' Prince the full time transvestite publisher of 'Transvestia'.
Transsexuals (a valid medical term before the onset of tg'ism and the she-male porn users) were in search of correction and a strong driven need to bring their birth contradiction of physical sex into conformity with their inborn opposite brain sex. It is that simple and has nothing to do with sexual orientation or the fetishistic drives of the majority of the transgender identifiers.
I am not transgender or trans anything. I am a woman having gone through transition and then surgery over 35 years ago. I look at transgenderism as simply a cloak to hide under rather than a distinct medical condition which I, along with many others, prefer to call, 'Harry Benjamin Syndrome'. This is now the term many of us use and we do so in honoring the man who gave so much toward our being understood for what and who we really were and are.
I did not 'trans' my brain gender, that was inborn. I did 'trans' my sex so as to meld with my female brain.
Let the fetishists and the week-end thrill seekers keep transgender. I will not accept that term unless every other woman on the planet does as well. Never will it be added onto my reality as if I too should be identified with a 'trans' prefix that does nothing but limit my womanhood as being something not whole but an element under a leaky umbrella term suited best to describe delusionists.
Diane Kearny

Why do bigots get to decide how a medical process is sought?

They bring this up and fight so that transsexuals are not allowed any treatment, and the consequences will be terrible. I guess if they want all those "disgusting trannys" dead than they're getting what they want. :/ My disorder is very serious and I need something done about it. If you intend to have GID completely removed from the picture, what will they do? Pump me with emotion-altering medication? They can guarantee THAT will be killing off a lot of "disgusting trannys."

This game of Russian Roulette puts MY life on the line and I consider it a direct threat.

If Blanchard and Zucker screw with GID in the DSM-V, then HBS people will be screwed the most because they will say that you are nothing more then men who had a sex change to have sex with men. It's their belief.

The best thing is to have it removed all together, then we can all go our seperate ways and nothing will bind us. Without GID in the DSM-V, it could go a long way to legitimize HBS. Think about it. Stigmitize one group and we all get painted with the same brush. It's what the HBS people have been upset about for years.

- "Transvestites were to grow into transgender as an identity. That is what and how it was proposed by Charles 'Virgina' Prince the full time transvestite publisher of 'Transvestia'."

Some transvestites, as well as some transsexuals, as well as some others, identify as transgendered; some do not. Transgender does not necessarily denote transvestite. And saying someone is a full time transvestite is an oxymoron.

- "Transsexuals (a valid medical term before the onset of tg'ism and the she-male porn users... "

"She-male" is just downright offensive and derogatory regardless of the designation of a person's gender identity, and you should definitely know better, Diane. If you think a right wing bigot sees you any differently no matter how many surgeries you've had, or whatever alternative label you apply to yourself, you have another thing coming.

- "It is that simple and has nothing to do with sexual orientation or the fetishistic drives of the majority of the transgender identifiers."

You have no idea what the majority of transgendered identified people think or feel; and the fact that you claim that you do, says a lot more about yourself than the group of people to whom you ascribe motives.

No one knows how many trans people there are, so you don't know what a valid statistical sample is; and there isn't a readily identifiable population to survey from which to gather a valid sample. So basically, you just made that up based on your own biases.

- "Let the fetishists and the week-end thrill seekers keep transgender. I will not accept that term unless every other woman on the planet does as well."

Here's the thing: You don't get a vote about what anyone else calls themselves. You can call yourself a gorilla if you'd like. Or a Harry Benjamin Gorilla if you prefer. But you can't call anyone else a she-male or a tranvestite or a fetishist or delusional. If you give up your right to define yourself, perhaps you'd get a bye on it. Probably not.

Diane did you really think this was the right time and place to post an anti-transgender speech?

This looks set to ruin the lives of all transexuals HBS and otherwise. The HBS women who are yet to get their hormones and surgery will be denied it and sent to reparative therapy right beside the transgender people.

We need to set aside the differences and arguments between HBS and Transgender for this fight because bringing it up now is just wasting time and energy desperately needed to fight this. Lets fight this side by side and then we can argue all you want about HBS Vs Transgender once the fight is won, otherwise we all lose.

Everyone is needed in this fight. The HBS women who need their hormones and surgery to correct the condition they were born with. The Transgender transexuals need hormones and where appropriate to the individual surgery too. The rest of transgender and gender non-conforming people have a stake in this too because if the medical system starts forcing transexuals to conform to birth gender that is going to flow on to the crossdressers and drag kings and queens and effeminate men and butch women.

This will effect everyone who doesn't conform to gender stereotypes. It will be trotted out at every senate hearing, parliamentary debate, courtroom and talk show.

The HBS women will need the Transgender people in this fight. We'll need every single person we can get. Every possible ally. Leave the divisions and differences aside for this fight. Argue about the 'evils' of Transgender in other discussions fine but leave those problems at the door of this one so we can stand side by side. We have a mutual enemy and we need to fight them together.

Once we are sure that these people are removed from this comittee and not replaced by their ilk then we can argue about how we think GID should be defined, whose theories are correct and all the rest, when this fight is over.

So,
How do we fight this effectively?

Batty,

When is the 'right' time to make it clear that those who need to have surgery to correct their sex are not the same as the elements under the transgender umbrella? When does the confusion end and when is the 'right time'?

I hope the ENDA never includes the 'trans' for it would simply place me and all others who had corrective surgery under the same definition of transgender identity. How then might we argue for separation and distinction and who then would even want to listen? I am not a fool and will not be trapped much like a fly in the spider web of confusion that is transgender.

I had my surgery in 1972 and not only did my conservative congressman aid me in the change of my documents but my church also changed my baptismal certificate which because of the transgender confusion those amendments are no longer allowed. When I walk out of my church I feel whole and not a fractured element that can always be found under the transgender umbrella. We need a distinct identity and one that does not mean we might be labeled as something that we definitely are not: a transgender mental disorder!

No problem back then convincing people that I had a medical problem and needed to have a correction and the only difference is that the delusionists under the tg banner now make it seem we are all a little bit alike. We did not need the fetishists then and we do not need them now.

I don't care what label they call themselves but to attach me to it is a travesty that I have come to know so well from many all over the world.
The following is part of our suggested Standard of Care that we presented to the APA and to other agencies. If you want the whole thing send me your email address and I would be only happy to send it to you:
***********************************************
Harry Benjamin's Syndrome was known in the past under many different names, transsexualism being the most common. However, Harry Benjamin's Syndrome is not transsexualism, at least not under the current definition of transsexualism provided by the ICD-10 which considers it a mental condition with a psychological cause.
As has been shown, Harry Benjamin’s Syndrome is a physical condition indicative of a fetal anomaly and to continue to categorize it as a mental condition is outdated and unfair; it wrongly denies patients with Harry Benjamin’s Syndrome essential medical care by placing them under inappropriate standards of care.

In 1980 Transsexualism was introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and fourteen years later, in 1994 it was changed to Gender Identity Disorder (DSM-IV). It is supposed to be revised again in 2007.

We hope that the condition will then be renamed Harry Benjamin’s Syndrome for the reasons we explain in the next section. We propose these differentiated levels of diagnosis.

The personal and emotional impact of this announcement are high for me. Which seems to require that the degree of careful rational thought be proportional to that impact. I've cross posted Mercedes post & links, and have received a few responses. This has lead me to ask further questions of myself.

1) What & How: What can I do to have any impact on this and how do I go about exercising any options? As satisfying as expressing anger, frustration, disagreement or annoyance may be personally, I fear that such expressions will not be heard by anyone who needs to hear them. In the worst case scenario, they might be dismissed as an attempt by the "inmate" (me) attempting to take charge of the "asylum" (the APA in this case). Therapists do not routinely allow their patients to direct the methods or guidelines under which they deliver therapy.
Academic structures are at least somewhat susceptible to peer pressure. I assume "professional" sympathy and advocacy would be beneficial. Peraps my own GP and therapist to start, but there are other gender specialist internationally who might not be commonly identified.

2) Who & Where: Where and who provides accurate and necessary information in an accesible method and where do we refer to if we need or acquire information ourselves? As has been pointed out, partial and presumed information opens the door to discrediting information itself. The emotional and personal importance cannot be allowed to taint the information.

3) Can we define a commonality of impact beyond our personal interests? I do not presume that my right to define my gender identity is in any way "secured". If the medical basis for transition is removed, I do not expect any legal right to self identify to be maintained.
If GID is removed from the DMS are there other, unassailable legal protections in place? I would not want to rely on a presumption that such protections will continue to exist or that they would be entirely maintained as is.
Both Blanchard and Zucker base their "treatment" theories currently on implied "homosexuality" and that implication is very much additionally treated as a disorder which necessitates "Treatment"
Could their influence return homosexuality to an inclusion in the DMS?

I don't see any of these questions as being alarmist inherently considering how poorly my rights have been served by the current DMS-IV. The addition of two blatantly anti trans appointees to the work group does nothing to lend creedence to an expection of improvement of conditions.

The hair splitting over labels of self definition becomes meaningless if you no longer have the right to self define.

From: MonicaHelms
"The best thing is to have it removed all together..."

No, because then the medical community would not feel any obligation to treat us at all -- no reason to prescribe hormones (which could become deemed a "harmful" act), for example. In removing GID from the possibilities for diagnosis altogether, we leave things like dissociative identity a.k.a. multiple personality disorder as alternate conclusions instead, for those troubled trans folks seeking help or youth being pushed toward help.

I certainly realize that the existing DSM-IV entry and WPATH SoC are (and have been historically) flawed, but I don't think anyone realizes just how much they do afford us at this point in time. Existing legislative protections could conceivably even become invalidated (deemed unnecessary or unjustifiable), without a DSM acknowledgement of GID.

While putting together a PowerPoint presentation for medical professionals, it's sobering just how much it empowers us to say that "yes, this is an established medical condition, and this is how the medical community has realized that we need to be treated." It's much more effective than, "uh, yeah, I know there's nothing that validates me here, but I really need to be a girl..."

From: battybattybats
"Diane did you really think this was the right time and place to post an anti-transgender speech?"

There are two elements in this that can only be expected to betray entire populations of people who fall under the current GID classification. They are HBS and HRC. The former will not be happy unless the TS-Si get absolute free reign on writing the new entry themselves, and exclude everyone that they choose to. I don't see a need to debate that part any further.

and
"So, How do we fight this effectively?"

What needs to happen is that there needs to be an uprising that includes our national and international organizations, includes the stronger voice of our GLB allies, includes the respected voice of trans-aware professionals in the fields of psychiatry and psychology, all directed to the board of the APA and its governance. If the national GLBT organizations are unaware, make them aware. If they are inactive, add another voice calling them to action.

I have sent alerts to various places, from NTAC to the NGLTF to OII to egaleCanada to WPATH, but it may take more than one person's say so to make them realize that there is an issue (actually, I suspect that NTAC will already be at work on this, and OII has already become active).

I have not contacted The Advocate, because they've been indifferent to things I've sent them in the past. Perhaps if someone has a contact there that they can whisper to and say, "hey, there's a story here...."

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Another typo. NCTE. For some reason, NTAC's webpage seems to be gone.

It's a medical issue, not a pshchological issue. Keeping it in the DSM stigmatizes us forever. The first step in making it a medical issue is to remove us from the DSM. Ripping the bandage from the wound quickly will hurt some, but overall, we will survive. GID does not create transsexuals, nor will it stop treatment for us.

Already, too many doctors could care less about GID and more about helping us, and they won't stop helping us. Those who will did not deserve our business in the first place. We will survive without GID in the DSM. Let's stop using it as a crutch.

Ashley,
Promise to not 'copy and paste' since you obviously do not want to read intelligent and relevant essays in fear of perhaps learning something. And I must be honest in saying that you compliment me by calling me a troll. At least you did not insult me by calling me transgender or worse still, a transwoman.
And what might you call relevant or is that a term not understood by 'trans' actors?
May I point out that many of us do not in any way identify with the acronym GLBT and find it ironic that most of the transgender are simply crossdressers/transvestites who are usually married to their spouses who share with them a number of children borne from a heterosexual union. The only fly in the ointment is that once in a while they sneak into their spouses clothes closet to find their thrills and demand I must accept them to be 'a little like me'. I live in the real world and not one of fantasy so how then might we be a 'little like'? Or do you mean that
'like me' you like a scotch and soda once in a while?
And Ashley if you take away the cover of transgender what might you identify as? Maybe I might understand you and what you are if not for that convenient transgender cloak that you and many other elements of the 'trans-club' hide under.
I know that I transitioned before the GID DSM affected those like me. I was not hurt by my not being classed under some dysphoric psychobabble and transitioned just fine having found after surgery acceptance and a wonderful life. But then we did not have the illusional identity that married us to the false dichotomy of the
'transgender' mix and match either. We knew what and who we were and were not searching for a 'could be or wannabee' inclusion.
Seems to me that so many favor being a 'trans' something rather than admit they really want not to trans their sex but only to once in a while
'trans' their brain gender to match their clothing or sexual options. Go to it but please do not jump on the bus taking those like me to another place...a life without delusion.
I know I am perhaps being simple minded but I will admit to love being a woman both mentally and physically without the delusionary baggage found so abundant under the Tg banner which is a non-medical construct offering no answers, only illusion.
Oops, did I offend anyone by my honesty in the face of their fantasy needs? I hope so!

Diane, we are trying to have a serious discussion here. Your comments only serve to make the issue worst. You may find more reseptive ears at an HBS site. 1972 is irrelivant in 2008.

As with all issues of this type that affect diverse and largely unconnected groups of individuals, any proposed change will generate fear. Fear mostly of the unknown. It is true that historically Blanchard and Zucker who ae not Doctors but researchers in the field of gender variance, have not been exactly friendly towards many sections of this particular community. We can only speculate at the moment as to what it is that this committe will come up with in the way of a new DSM (V) Perhaps it will have benefit though it is more probable that it will contain adverse conclusions for some groups and benefits for the rest.

As it happens none of it will affect me but that is no reason for me not to be concerned. There are those currently affected by the presence of their condition within the DSM that would probably benefit by the conditions removal though I rather doubt that any condition currently defined as psychological will be removed. It is much more likely that the recomended treatments will be changed as part of the standards of care for the various conditions.

Some here have called for a degree of unity among those whom are affected by the possible changes to let our feelings be known as some collective and united group of like minded patients of a flawed medical diagnosis. However, the reality is that for as long as I can recall the so called community has been at each others throats as treatment regimes that suit one section are applied by doctors to those who believe they belong in another medical diagnosis, psychologocal or medical. The creation of a united front is simply not practical let alone feasable.

My own experience in this field as a practitioner and a patient has me agreeing with some aspects of Blanchard and Zuckers work and disagreeing with other aspects of the work. I have also been in a position as a practitioner, of oposition to a patients diagnosis of themselves and my own diagnosis of what it is that affects them. This particular field is full of so called experts who self diagnose as well as diagnose each other. I have observed many tragic outcomes caused by such situations.

My own opinon for what it is worth is that there are several quite different conditions that exist that the DSM lV has attempted to cover some and one in particular has no place being treated as a DSM issue. In point of fact a few medical practitioners avoid making a psychological diagnosis and treat the condition as medical. Intervention by psychiatric pratictioners is not then required under medical ethics guidelines.

One thing is certain however, calling each other names and making personal attacks is not going to get Blanchard/Zucker off this committee. Perhaps if you all had opposed Anne Lawrence's inclusion in WPATH in the first place this may have been avoided.

Enough, already.

I'm a firm believer in the neurological theory, often called HBS, and that's because there's so much evidence for it, and none against.

But many of the proponents of HBS the movement aren't aware of the implications of neurological causation.

First, there is no such thing as a "male brain" or a "female brain". Brains are complex things, with many distinct interacting parts. Masculinity and Femininity follow a bimodal distribution, that is, there isn't a continuous gender spectrum, but a distribution with two distinct peaks. Men and Women are distinct, neurologically, but it's not that simple. I'll try to explain.

Say the brain only had 6 parts, instead of thousands. And say the spectrum of characteristics of each were simplified to M - strongly male, m - weakly male, n - neutral, f - weakly female, and F, strongly female. A gross simplification, but you get the idea.

Few if any MMMMMMs and FFFFFFs would exist. The violent rapist Mike Tyson might come close to being MMMMMM, but in any event, such people would be abnormal and not particularly sane.

Most women might be FFfnFm or fFffmf for example. I'm talking about women in general, not just TS women.

Now if the first character corresponds to the bit for gender identity, then anyone with F or f there is a woman, regardless of the rest. And suppose the last character is the bit to do with body image.

Most women would be FxxxxF, Fxxxxf, fxxxxF, or fxxxxf. But some might be Fxxxxn or even Fxxxxm. FxxxxM's probably don't exist, there's limits on how screwed up a cross-gendered brain can be.

So an Ffmfnn TS woman would be rather un-feminine, might even be lesbian, and might not think the risk and cost of surgery would be worth it. She can function adequately, not well, but adequately, despite masculinised genitalia. Probably anorgasmic, but no big deal.

If evaluating myself, I'd say something like fmFfnf. A gender identity not so strongly feminine that I couldn't do the boy act for decades. Some typically male traits - like many female engineers. An unusually strong maternal instinct. Sexually straight now my hormones are correct. Almost neutral as regards personal appearance, I look like an unmade bed and really should do something about that. And I could have lived without genital reconstruction if I had to, though it would obviously have precluded any sexual activity. I'm very glad I didn't have to live without it though! About as glad as I am that I'm not blind, and am not paraplegic, both conditions I could live with if I had to, but am glad I don't have to.

The point is.... if this is biological, which I'm convinced it is, then people will be affected in different areas and to different extents. There will be women who look stunning, are utterly feminine in their gender identity, but whose mannerisms will scream MALE unless trained out of them. There will also be old chooks like me, plain geek girl middle aged tomboys, whose general demeanour means that many can't believe they've had a transsexual past. Different parts of the brain, you see, I got a strongly feminised hindbrain, the bit that controls instinctive movements.

I'm technically IS rather than TS, and I know people best described as nfnMfn and the like. IS people to whom, unlike me, the whole concept of gender is really irrelevant. Not many, most IS people are M or F, but some aren't either.

Summary: while desire for surgery is a good metric, it's about as reliable as 46xx chromosomes are for determining who's female and who isn't. There are exceptions, distinct from the majority not desiring surgery who at first glance appear the same, men with a sexual transvestite fetish.

I can neither be as fanatic about surgery as the HBS political movement, nor deny that from the evidence, HBS is very real.

I know IS women with 46xx chromosomes and partly masculinised genitalia you see, who aren't so uncomfortable with that that they want to risk surgery that could leave them incontinent and anorgasmic.

I also know quite a few transvestite men who get a thrill from dressing up. The difference between them and women is obvious. I only got to know them so they could teach me to dress a rather too ambiguous body in female clothing, I'd never tried that before transition. TG they may be, but not TS and there is a difference. One requires medical treatment, hormones at least, the others don't. I think that's the best practical metric.

This issue is one where we need to be decisive and not divisive. The Transgender American Veterans Association board is formulating our plan of action as we speak. We have to act in a manner that will help our veterans, which will also help all of us. TAVA knows how to be decisive. We'll let you know how we respond to this.

In point of fact a few medical practitioners avoid making a psychological diagnosis and treat the condition as medical. Intervention by psychiatric pratictioners is not then required under medical ethics guidelines.

Evangelina, that may be irrelevant when we're talking about political and legal situations, which for good or ill are advised by the DSM.

Example: the Wisconsin Inmate Sex Change Prevention Act.

If late transitioners are all going to be classified as paraphiliacs in the DSM, along with fetishists, necrophiliacs and the like, what are the odds of us retaining the ability to change birth certificates, marry, or even legally access to hormones or surgery, no matter what medical professionals may deem necessary? Ray Blanchard may think we're still entitled to treatment even if so classified, but I think most legislators would differ.

The medical issues concern me. The legal issues terrify me.

If MassResistance and the like can say that "autogynaphiles are classified by the American Psychiatric Association as being similar to sadists and paedophiles", the situation for gaining or even retaining basic human rights is bleak. We've had some of this already as the result of the DSM-IV, but we've managed to rebut it. If it's explicitly stated in the DSM-V, we're toast. Even the Intersexed like me.

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Hi, Jennifer. I haven't heard from you in awhile. How's life treating you? How's the job? You still living in San Francisco, or did you move back to Alabama? We need to catch up.

actually Diane Kearny, according to the requirements for HBS, you yourself would not qualify for treatment.

By posting here under your name, and my maintaining contacts with your church you are not totally stealth, thus violating one of the key requirements for HBS.

other requirements that other posters may not be aware of...

- must have, or want, full genital surgery (medio does not count, must be full phallo), and chest surgery (for the guys) or facial surgery (for the ladies), regardless of ones personal health
- must be on, or want to take hormones, regardless of ones personal health
- must be heterosexual
- must be deep stealth, have no contact with anyone from before transition (including family)
- must have a 100% gender normative presentation (MANLY men, and GIRLY girls... nothing in between... if you're not working on truck engines or wearing a skirt and cooking all day you're not good enough)

If you miss even one of those, you are NOT HBS, and will not have access to treatment under an HBS system.

Zoe Brain, your "large amounts of evidence" consists of 4 studies, all of which done on less then 40 people (total, including the control group, only one of which contained any transmen and that study had exactly ONE transman in it. Add in the fact that all four have been tossed out due to amazing amounts of sampling bias and a very generous use of the word "trend"... the whole thing falls apart.

now there MAY be a relation, however there has been nowhere NEAR enough study done to base any kind of theory or treatment behind it.

Kaitlyn, my dear girl I suggest you restrict your comments to things you know something about, otherwise as has just been the case, you end up looking like a bigotted idiot and I am sure that is not what you are.

I strongly advise you to do some research on definitions surrounding HBS and too this end you might like to visit the web site. Relying on hearsay and biased chat forum folklore has clearly not served you well thus far.

Poor Kaitlyn,
You are so very misinformed. But then transgender is a term seen as a positive for the misinformed.
I use my maiden name, not my married name. And add to that the fact that I attend church as the woman I am and not as a characterization of the opposite sex. I am not like those who might advertise their fetishism in front of such places as the Vietnam Wall and make claim they are representing transsexuals.
Yes, I live a rather stealth life and that is simply because I live being accepted as the woman I am and not a tranny. I will even be buried when my time comes in a Veterans National Cemetery where I will join my late husband. Or would you and the other transgender demand I be out and join the transgender support clinics that the APA and even WPATH think a good meeting place for the peer groups of trans-folk. I few blood family left but I do have very close friends who know of my past yet cannot relate to that facet of my life for it is not what I am. My husbands family are not privy to the error of my birth but then neither are you. Zoe might, but you would not! Hard for you to understand perhaps but that is truth and not a fictional account driven by TG pretense.
Zoe is absolutely right on the research. In fact more than one BSTc study done and more studies by the Swedes in regard to genetic linkage to transsexuals. And the only holdup on further research is the transgender politico's would not like it and do not support further funding for it would not support a legitimacy for 'dressing up'. It would also remove their false attachment to those born with a medical condition separate from their own temporary urges and desires
The funding is held back in fear that support research would find that a man with a fetish is just that; has nothing to do with a congenital birth condition.
In the group I belong to quite a few are not heterosexual but are HBS born yet in same sex relationships. I know you don't understand what HBS really is so rather than deal with your ignorance I will just go back to my efforts in gaining separation from the misinformed so that I might deal with reality and not inclusion under a leaky 'trans' umbrella term.
And Kaitlyn, you attacked Zoe on the amount and number in the studies done that clearly indicate a fetal congenital anomaly explaining why a person is born with a body in contradiction to their brain sex. At least these are valid studies although limited but, even using all of the search engines available, I still cannot find one single study that defines transgenderism as anything but a non-biological construct.
It is a fact that those who are HBS born do remember those years before puberty realizing that they were born the wrong physical sex. HBS defines those who realized long before puberty that they were born the wrong physical sex in opposition to their brain sex. A transvestite cannot grow into being HBS; an autogynephilic is anything but a HBS born and doubtfully even a transsexual but simply a transvestite who needed to explore his/her fantasy to the extreme; puberty does not trigger HBS, it is inborn. An HBS born person is not nurtured as are many under the transgender banner but instead are a result of a natural anomaly that took place in the womb... a neurological intersex biological condition according to many professionals such as Dr Diamond and Dr Benjamin and not much different than Kallman's Syndrome, AIS, PAIS, etc.

Sorry Kaitlyn, I don't know where you are getting your information from, but you are quite wrong on several counts. First off, you presume to "know" that Diane is posting under her real name. Just because you think someone is, does not make that a fact. Just as Helms presumes to know who I am. Second, your surgical requirements are laughable. There has been some debate among those actually involved in advocating for the term Harry Benjamin Syndrome as to the proper requirements for FTMs, but there has never been any suggestion that a medioplasty is not sufficient. And the idea that all require FFS is laughable. Nor is there any requirement that one be heterosexual, have no contact with family (or others), and there is no requirement as to presentation. Are you making this stuff up, or have you been mislead by someone?

Sorry, but your facts, simply aren't.

I find it sad that some are so dismissive of the HBS view. While I realize that it represents a strong rejection (and quite effective rebuttal) of the "transgender paradigm" so favored by some here, that does not give them cause to be so condescending.

As to removing "GID" from the DSM, I have to agree that this would give many an excuse to no longer offer treatment. But, then again, it is true that GID is not necessary. In my own case, my therapist declined to put that diagnosis on my record. I was simply certified as needing surgery to correct my situation.

In a sane world...

There would be a psych condition, Gender Dysphoria, which can be caused by an Intersex condition (including the deduced HBS). Those with an Intersex condition but without GD don't need treatment: those with the GD need treatment for the underlying biological cause, and then the GD would go away, and be recognised as cured.

Treatment of the underlying biological cause, with hormones and in some cases surgery, is the only effective treatment in all but the mildest cases.

Some residual GD may be present due to deficiencies in the treatment - depression due to being unable to bear or father children for example.

There would also be various second-order co-morbidities that can be caused by living with GD for a protracted period. Not all who have GD have these conditions, and curing the GD may have little or no effect on these secondary effects - much as liberating someone from a rape camp may not give relief from the trauma experienced there.

There would be various differentiators to distinguish diagnoses, as now.

We're not that far away. But the more neoFreudian psychobabble that's added to the mixture, the more we'll have situations where those who don't need surgery (IS infants) are given it without consent, and those who do need it (TS adults) have it withheld. And all will suffer legal persecution based on false premises.

"Priveleges" and "rights" often seem to be entangled so deeply that its impossible to separate them. In practice, rights usually have at least some legal basis; priveleges are the individual benefits I can access by extending personally the application of my rights. Priveleges are often only assuptions I make about the scope of a right in my personal interpretation of how I exercise a right. Assumptions that may have no legal basis, but which also do not create enough impact to be called into question.

Without a legal basis, rights can and are denied all the time. Women in American have a legal right to abortion. I personally view this as an inherent absolute right of all women. Yet this is not extended as a universal, international right. This right, where it does exist at all, is frequently susceptible to a number of additional imposed and conditional restrictions, and even removal. Socio economic class and race set up various conditions for privelge access to this right as well.

I see gender "rights" (and the benefits of extended priveleges) as having significant parallels. But without the indisputable conclusiveness that women can assert in regard to reproductive biology. If the fact that a woman's right to control her own body/womb may be questioned, how can I feel certain my gender identity (which despite all the new evidence is no where near as conclusively defined), will not be questioned, revised or even removed?

The security of having completed transition, however long ago, will only remain secure as long as it has a legal basis. My objections and fears about the appointees to the APA work group are based on the inclusion of Zucker and Blanchard and the perspectives from which they view gender treatment. Blanchard labels all post operative (he makes no distinction for HBS women) as "men without penises" I find it conceivable that legal female status could be revoke, if his and Zucker's definitions of gender variance are accepted as even part of the guidelines of diagnosis.

At 57 years of age, the impact of any of this on me personally is really quite negligible. My emotional engagement may be purely selfish and egotistical. But I don't want my own confusions, conflicts, struggles and pains or my successes, joys, indulgences and accomplishments to have been for nothing more than my own gratification. I know I didn't get to the point where I could feel comfortable with my gender on my own. I did it on the efforts of many known and unknown others, sometimes enemies as much as friends. That comfort has been a great privelege I've enjoyed. I think it should be everyone's right instead.

Another serious discussion sidelined by the destructionists. It's obviously time to redirect our energies on this matter.

Zoe, interesting idea there that sounds like it would result in a seeming spectrum because of the number of variables. Sounds like potentially a neurological cause for what is called transgender to me as it would result in quite a wide range and many different gender expressions. That would make both viewpoints right and both wrong. A neurological cause, seemingly distinct yet also related groups with varying needs, a seeming spectrum.

As for the contuinuing HBS Vs Transgender debate.. good grief people! Try and be more respectful. I do agree that there seems a distinct neurological cause for some transexuals.

However the assumption that their isn't for everyone else and that everyone elses feelings are 'illusions' and that they are 'actors' is offensive and needless. (and those who object being catagorised by others as Transgender really shouldn't be catagorising others, thats a clear double-standard)

There's neurological evidence for sexuality too, so to assume there isn't for other things/gender or sexual is simply that, assumption. There was even a case where someone developed paedophillic desires after developing a brain tumour that ceased when the tumour was removed so that too could have a neurological cause (my source was a discussion on ABC Radio National, the science show I think but it may have been the psychology or philosophy shows that are broadcast imediatly after it).

Making lots of negative comments and implications about crossdressers and fetishists is itself quite bigoted. Whatever the cause they should be given the same respect as everyone else. Whether neurological or sexual it's still ethical. If it's just another of the complex neurological combinations as Zoe describes then it should be respected. If it's source is sexual yet still ethical like, say, being gay or lesbian, then it too needs to be respected!

So no matter who is right about the explanatory theory there is no excuse for looking down on or being offensive about crossdressers etc.

But changing the topic of this discussion from 'oh the horrors, someone who treats children with reparative therapy is in charge of the comitte to redefine GID, something must be done to stop the harm this will cause' to 'My theory is better than yours so everyone on your side is a bunch of -----' is counter productive to a ludicrous degree.

leaving this situation unchanged could harm all transexuals no matter whose theory is correct as to why they are transexuals. The point is people who need the surgery may not get the surgery if this person has an undue influence. Everyone has something to lose snd every voice is needed to speak out against it.

We don't have to agree on what viewpoint is right to agree that these people being on that comitee is wrong!

A fair point Mercedes.

One has to wonder what was going on in the minds of the APA when they chose the committee members. These people are not fools and are not unaware of the feelings of many patients towards the two appointments we are discussing. The have to be aware of the feelings of patients towards them. We can only speculate. However who is going to make the protest to the APA?

Press for change in the UK are currently asking for someone with a medical background to take up the cause on their behalf; but it is hard to think of anyone in the UK who would be prepared to do it. The current leading UK practitioner is a Blanchard desciple and on the WPATH board.

Prof Milton Diamond may be a candidate but his views may not suit many of the TG community. So who else is there? I think This is a situation where interested parties should start writing individual letters addressed to APA asking for an explanation for why two of the most controversial figures among patient advocate groups have been appointed to review their care.

That, as Forest Gump would say, is all I have to say about that!

My sentiments exactly, Mercedes. It's amazing how quickly the "dogs of war" come nipping at your heels when the status quo is challenged. Of course, it has been my experience that gender different people are good at trigonometry. They know how to go off on tangents. As you can see here, some are so good that their tangents even go beyond three dimensions. Einstein would be stumped.

"Picture this. A lonely man, one who has never had any friends, goes through his daily routine, but today, something will be different. Today, his body decides it has had enough. Today, a change takes place. Today, his penis becomes a vagina. Because today, she has crossed over into . . . . The Trannie Zone." (Insert theme music here.)

it has been my experience that gender different people are good at trigonometry. They know how to go off on tangents.

LOL, Monica.

As a member of the edteam, I think it's awesome that there is so much spirited debate about this topic. It's clearly needed. But may I please remind you to remain adults about the dsicussion and refrain from the personal attacks?

Thanks in advance for making my job easier - deleting comments that violate TOS takes a lot of time.

from your own SoC
http://shb-info.org/id34.html

which I notice has very few doctors names attached to it...

some choice quotes:
"Persons born with Harry Benjamin’s Syndrome are born with male and female characteristics" (no transmen?)

"In order to properly realign the person’s body to its proper brain sex the treatment will include Hormonal Replacement Therapy (HRT) and Sex Affirmation Surgery (SAS)." (notice the "WILL include" in there)

"The treatment of this condition includes HRT and SAS." (again with the forced HRT and surgery...)

"As an example, many girls with Harry Benjamin's Syndrome have clearly feminine physical forms and bone structure prior to starting HRT." (that policy is right out of the Clarke, refusal to treat transgirls who "aren't cute enough")

I could continue, however it is bed time and my husband has that "come hither" look.

Diane,
I just read this article http://www.npr.org/templates/story/story.php?storyId=90247842

Both of these examples sound as though they could be future HBS Women.

We have two therapists, one who agrees with the Transgender idea.. and Zucker.

Now just from this article it seems safe to say that the child with the Transgender accepting therapist will grow up to get full SRS if they feel they need it. Their needs as an HBS woman will be fulfilled.

The child treated by Zucker on the other hand...
if they are HBS they are clearly being harmed.

So really, who is the greater enemy of the HBS women of the future? The Transgender accepting therapist who seems to just let the child be themselves naturally so that a physical transition would be easy and possible in the future or Zucker who is trying to force them to be boys, to give up girl things?

Really Zucker is clearly an enemy of HBS. The Transgender accepting therapist, while not fitting exactly the HBS view, still allows HBS kids to grow up and become what they will become.

And it is Zucker right now who is situated to cause the most harm to the next generation of HBS women.

Irrespective of who is right and wrong in the HBS Vs Transgender argument, we have a common enemy in Zucker.

Fighting amongst ourselves is only going to distract us from fighting Zucker. It is going to weaken out capacity to defeat Zucker.

Think of the HBS girls yet to transition who may be denied that by this man. Think of the HBS girls who will suffer years of trauma because of this man.

Lets try an analogy. One of us is the USSR, the other the USA. Zucker is Nazi Germany. We can have a cold war afterwards, or even a hot one. But fighting each other long before we reach Berlin is not a good idea. We don't have to join out armies together, we can fight on different frontlines, but if we shoot each other while he is strong we weaken each other and thereby strengthen him.

Consider it a while. Read this while your thinking about it http://www.npr.org/templates/story/story.php?storyId=90229789

And think of those little HBS girls under Zuckers care. Think of what they will go through that you know won't work but will cause extreme suffering and harm.

One of the most common accusations made by those in opposition to HBS is the clear and precise way it is defined. Fall within the definitions, you have HBS or have been cured of HBS. Fall outside the definitions, you do not have and have never had HBS. There you are say the detractors you are all elitists. HBS is a medical condition and as such requires quite precise symptoms in order to make an assessment of diagnosis on the condition. So in this respect it is no different to any other medical condition. It is patently obvious that you cannot have the symptoms of sclerosis of the liver and claim that you have lung cancer, that is of course quite ridiculous and no one would do it, well not anyone in their right mind would do it.

So why when a condition has clearly outlined symptoms and defined causes is that somehow wrong? I have to say it has me quite perplexed.

No where on the HBS web site or within the suggested standards of care does anyone say that those who fall outside the definitions should not get treatment for another condition. The treatment may well be similar. For example; you might take a course of antibiotics for a tooth abscess; similar treatment would be prescribed for an infected wound. However the need for the treatment is different. So it is really quite simple; if there is an absence of need for surgical intervention, then the cause is not HBS. Why is that seen as wrong? Yes in the standards of care that HBS advocates are suggesting, it is made clear that a strong desire for surgical correction is always present and this need should be met. If there is no desire for correction HBS is NOT present. Why is that wrong?

If an individual chooses to live their life appearing to society as the sex opposite to their birth, I really do not have a problem with that. However if they make a choice not to undergo surgical intervention then the cause of their choice is something other than HBS and should be treated in a quite different way to that which HBS is treated. Both conditions require a quite separate set of standards of care.

Let me quote what Kaitlyn said in her post. By the way I commend you Kaitlyn for taking the trouble to do some research.

"As an example, many girls with Harry Benjamin's Syndrome have clearly feminine physical forms and bone structure prior to starting HRT." (that policy is right out of the Clarke, refusal to treat transgirls who "aren't cute enough")

You have not made yourself quite clear here Kaitlyn but I gather from the tone of your post that you are critical of the assertion that along with a hypothalamus that has developed in a manner opposite to genitals there are other accompanying secondary sex markers. Physical characteristics that are more suited to the hypothalamus than genitals. There are probably also secondary sex markers that will be more aligned to the genitals. However the weight of the secondary markers will always follow the hypothalamus. Your criticism is presumably that you would be concerned that treatment may be withheld if the person was not “girly” enough or not “manly” enough. That is a fair point and you are right to be concerned. However, again nowhere on the web site do we say that we condone the refusal to treat. We do say however, that the treatment should be made for the right reasons and not for reasons borrowed from someone else’s condition. In other words do not ask for a lung transplant because you have liver failure.

You also state:

The treatment of this condition includes HRT and SAS." (again with the forced HRT and surgery...)

Why is that a problem for you? All we are saying is that if the individual does not seek surgery then they do not have HBS. If they want to live their life in the gender opposite to their birth then fine, but do it because they are “Transgender or transvestite” not because they don’t like that term and prefer to use a descriptive that is applied to a condition they do not have.

Those who do have HBS have just got to the end of their patience with being called something we are not. I daresay if someone began calling you a Parrot you’d pretty soon get fed up with it. Well so it is with those who have HBS we are tired of being called transgender. We do not hate those who identify as transgender, we do not seek to deny you treatment we just ask that you seek it for your reasons and not ours.

Over the years, I have observed the behavior of several women who started transition back in the 60s and 70s, before the Harry Benjamin Standards of Care were first established (1979.) The gatekeepers back then were all men and they had a very male attitude for those women who wanted surgery. This attitude translated to various restrictions that have long since been discarded.

Back then, a person had to look female without facial surgery, had to have a small built, had to be a professed heterosexual, had to quit their jobs, move to another part of the country, not get a job until they were approved for surgery and couldn't reveal their past to anyone. It's as if the gatekeepers were the Borg making sure we assimulated correctly into the collective.

I have heard of horror stories of how those gatekeepers would browbeat the women into jumping through all the hoops, threatening to withhold hormones and surgery. You don't tow the line, you're screwed. This was a form of brainwashing that was unique to our people.

This constant brainwashing and threats have messes with the minds of those women to the point that they lash out to anyone who crosses them or who don't follow the teachings of their gatekeeper gods. Some famous TSs who transition back then tell the tale.

Wendy Carlos (who didn't change her job) gets hostile to people who just want to thank her for being a pioneer. Rene Richards (became very public) regrets what she has done and recommends psychodic drugs instead or surgery. Lynn Conway has done a lot of good things, but I heard from people who have dealt with her personally that she starts ranting and accusing a person that they "consider her a man," even if the disagreement is not trans related.

I don't blame any of these women for how they act today. It isn't their fault. The gatekeepers screwed with their minds and we are now seeing the negetive results of that. HBS is an offshoot of those early gatekeepers. The one thing that I smile about is that in 20 to 30 years, all of those women who suffered at the hands of those gatekeepers will have passed away and those trans people who are being born today will be far more accepting and understanding of everyone's situations. I would love to see it, but I was born 50 years too early.

Diane,
I just read this article

Both of these examples sound as though they could be future HBS Women.

Di> No, both examples are what appears to be HBS born children.

We have two therapists, one who agrees with the Transgender idea.. and Zucker.

Di> The problem as I and many others see it is the term transgender to begin with. Children are born with either a primary female brain gender or a male brain gender. Their anatomy might be the opposite sex but gender is not a variable except for those who might see trans-gender as being a correct term applicable to those not HBS born but nurtured as Zucker puts it.
Zucker is not much different than Money in that he thinks gender (brain sex)is something acquired after birth and can be changed through manipulation. Most of us know how that disaster ended up.

Now just from this article it seems safe to say that the child with the Transgender accepting therapist will grow up to get full SRS if they
feel they need it. Their needs as an HBS woman will be fulfilled.

Di> You confuse transgender with HBS. Not the same.

The child treated by Zucker on the other hand...
if they are HBS they are clearly being harmed.

So really, who is the greater enemy of the HBS women of the future? The Transgender accepting therapist who seems to just let the child be
themselves naturally so that a physical transition would be easy and possible in the future or Zucker who is trying to force them to be boys, to give up girl things?

Di> Again you seem to use the transgender mix and match model and add HBS to it. HBS is not an element under the transgender behavioral identities.

Really Zucker is clearly an enemy of HBS. The Transgender accepting therapist, while not fitting exactly the HBS view, still allows HBS kids to grow up and become what they will become.

Di> I agree Zucker is an enemy of HBS but also an ignorant man.
I listened to his long winded regressive talk when I attended the transgender symposium in Chicago last year.

And it is Zucker right now who is situated to cause the most harm to the next generation of HBS women.

Di> The harm is already being done not only by the Zucker types but from all who seem to think that the HBS born should be treated as a sub-set
under the transgender banner. One is medical and the other obviously includes gender variants some of which are behavioral and others who simply want to express their blatant gender deviance.

Irrespective of who is right and wrong in the HBS Vs Transgender argument, we have a common enemy in Zucker.

Di> Common??? How so? HBS born need a medical solution. An evaluation by a competent psychriatric specialist should be a matter
of course but only to determine if actually HBS born or transsexual.
That should be the end of their involvement except if the patient requests help in moving past the initial turmoil caused by the
contradiction of physical sex to brain sex.
Most transgender want a politically driven privilege as I see it and the majority would never want to change their sex except perhaps those post surgical who identify as autogynephiles who self admit to being
transgender fetishists as does Lawrence one of Zuckers 'friends'.

Fighting amongst ourselves is only going to distract us from fighting Zucker. It is going to weaken out capacity to defeat Zucker.

Di> Where were the 'us' when we fought against the inclusion of 'us' under the transgender banner. No, as long as we are added to the
confusion generated by the social construct of transgenderism there will never be a favorable outlook for HBS born. How about those who
replaced HBIGDA with WAPTH without even a discussion with their own members or those directly affected. The transgender spit in the
face of every HBS born and even many of the transsexuals when that happened and for their own reason. It served their purpose to have an
organization geared to their needs all the while ignoring ours. Zucker, Blanchard, Lawrence, Dreger and many others influence WAPTH far
beyond Zucker alone and most of them I know actually agree with him.
If you want progress, get rid of the whole board at WAPTH and turn it into a real transgender support group and when doing that leave those
searching for surgical relief to form a group dealing specifically HBS and transsexual needs.

Think of the HBS girls yet to transition who may be denied that by this man. Think of the HBS girls who will suffer years of trauma because of
this man.

Di> Where were the voices in the past when Zucker was practicing his dictatorship? Why now the concern? Perhaps only now because of his being able to rant from the board room of WPATH which might even affect those who demand privileges that parallel actual HBS and TS but who have no desire or need to be physically the opposite physical sex.

Lets try an analogy. One of us is the USSR, the other the USA. Zucker is Nazi Germany. We can have a cold war afterwards, or even a hot one.
But fighting each other long before we reach Berlin is not a good idea.
We don't have to join out armies together, we can fight on different frontlines, but if we shoot each other while he is strong we weaken each
other and thereby strengthen him.

Di> Separate fronts are fine with me. That is my wish. Not to join with the confusion generated by transgenderism but to fairly and effectively make aware to all that being born with a condition is not the same as acquiring a behavioral pattern later on in life. That is the goal and message of all the HBS organizations all over the world.

Consider it a while. Read this while your thinking about it http://www.npr.org/templates/story/story.php?storyId=90229789

Di> I have not only read like stories but lived through it as a child.
I know how it is to feel alone and physically abused by my peers only because I was 'different' and be refused help by Johns Hopkins because I was too young for treatment even if parents would give consent. I do know how later I came to be directed to Dr Benjamin who did not confuse me with those who now identify as transgender. I KNOW THE DIFFERENCE HAVING LIVED THROUGH IT.
Diane

And think of those little HBS girls under Zuckers care. Think of what they will go through that you know won't work but will cause extreme suffering and harm.

Look, as someone who suffered years of physical pain, worsened illness and loss of quality of life because doctors couldn't seperate out Chronic Fatigue Syndrome/Myalgic Encephalomyelitus from Ross River Fever, recurrent viral infections and dysphoric depression (I just had the CFS/ME, but many researchers are still having their data skewed wildly by not screening out those with dysphoric depression etc) I'm rather sympathetic to the whole HBS thing, even though the way it is expressed seems often to come across as downright hostile towards and an excuse to be bigoted towards those who consider themselves transgender but do not fit within a simple binary model. I'm sure not every HBS person does this but thats often the impression that the way some discuss crossdressers et al gives.

From my understanding I do not see why it is so important to split the one from the rest as I don't see that an HBS sufferer and a transexual who also requires surgery differs in any way in what treatment they need or the causation, seeing as insuficient research has been done to difinitively state that they have seperate causes rather than just alternate models of explaining the same phenomena, one narrow in definition and the other not.

I have experience there too. Fibromyalgia, Chronic Fatigue Syndrome. Same condition? Neither as a name or medical definition works very well. (oh and for anyone reading this that has the impression that CFS is like feeling tired all the time, one study found it is the suffering equivalent of the last two weeks of dying of cancer, but lasting 18-months to many years. I've had it more than 16 years, though diagnosed as such for a lot less than that)

Each are rather a catch-all term for what may well be a range of related but different conditions with evidence of changes in cerebro spinal fluid, loss of quality of celular replacement (a number of people lose heir fingerprints.. think what the same phenomena is doing to their hearts!) long-term damage caused by brain swelling, epigenetic changes involving immune function and energy production inside the very cellular level of the mitochodria and more appearing in much but not all of those with the condition. Both appear to be post-viral infection physiological responses that take far longer than the initial infection to dissapear (18-months+, often years) and sometimes remain permanantly.

The difference? One seems to have less exhaustion and cognitive impairment and more physical pain and stiffness of joints and the other the reverse. Both share the same range of symptoms, but are divided on quite arbitrary definitions of proportion. We could easilly grab a portion of the sufferers of fibromyalgia who suffer no 'brain fog' whatsoever and call it a seperate illness by making the lack of brain fog a neccessary part of the definition. We could even decide it only counts if the person is wheelchair bound or bedbound.

We'd still be splitting hairs.

However people with various depression subsets who feel tired all the time and share most of the rest of the common symptoms but not all or the cause will get better with regular aerobic excercise, people with CFS/ME/FM will get profoundly worse and may even die if forced too far. So when, because of the skewed data, it became standard advice to doctors to get their CFS patients excercising it was a serious problem.

I certainly don't dissmiss the posibility that there is something in the idea of HBS and I'm all for letting people determine and identify however they want to, but I don't yet buy that it is totally medicaly seperate. The line drawn seems too arbitrary. When sufficient neurological studies have been performed to ferret out which transgender(and HBS etc) phenomena is neurological in causation and whether any are not (certainly Zoe's post on neurology is intriguing and just may well validate all transexualism HBS and not, perhaps even all transgenderism, as variations of the same phenomena) then we will have the answer and we can put this argument to rest.

But if an HBS person is treated as transgender and some transgender people still need HT and SRS then I don't see how the HBS people are being failed by that, they'll get their HT and SRS as it will be seen that they still need it. Sure not all TG people need SRS though some do. Just as not all CFS/ME/FM people need wheelchairs arthritus medications, vitamin injections or restoration of gut flora but some do.

If on the other hand it was more like CFS sufferers going from being moderatly active to wheelchair bound for years or suffering heart damage because they were forced into a treatment only appropriate to people with depression then I would thoroughly understand. Say, if all transgender people and HBS people were treated as if they were all just one transgender sub-set, like crossdressers so no-one got HT or SRS, then there would be a great point.

But as I keep saying, and I must admit to becoming very confused as to why I have to keep pointing this out, this topic isnt about the merits of one explanation over another. This topic is that someone who disagrees with all of us is in a position of power that will effect Transgender and HBS alike in a really bad way.

The HBS people could win their argument here or lose it and neither outcome would make the slightest difference to Zucker and what Zucker could do to everyone.

Wouldn't it make, maybe just a tiny hint of sense, just at least a little bit, to debate elsewhere (even elsewhere here at Bilerico, but in another topic all it's own) the pros and cons of HBS as a medical or cultural distinction from Transgender and to actually work here together in this one formulating tactics and strategy for activism to get Zucker off that comittee?

Or is there something remotely to be gained by turning this discussion away from Zucker and focusing entirely on the HBS Vs TG debate that has nothing really to do with Zucker?

Zoe,

Why would the term "gender dysphoria" be any better? I was not dysphoric about my gender, which was always female. I was born with a disjoint between one physical part of my body (my brain) and another physical part of my body (my genitals) and I corrected that.

Such is the nature of HBS, which is totally different from anything that can properly be called "transgender."