Talk:Transsexualism

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[edit] The definition of transsexualism according to the APA

Yes let us use the APA/WPATH definition. 8) This is the compleat specification as found in the DSM IV According to: Genderpsychology.org DSM IV and every place else I have seen it.

Differential Diagnosis Gender Identity disorder can be distinguished from simple noncomformity to stereo-typical sex role behavior by the extent and pervasiveness of the cross-gender wishes, interests, and activities. This disorder is not meant to describe a child’s nonconformity to stereotypic sex-role behavior as, for example, in “tomboyishness” in girls or “sissyish” behavior in boys. Rather, it represents a profound disturbance of the individual’s sense of identity with regard to maleness or femaleness. Behavior in children that merely does not fit the cultural stereotype of masculinity or femininity should not be given the diagnosis unless the full syndrome is present, including marked distress or impairment.

Tranvetic Fetishism occurs in heterosexual (or bisexual) men for whom the cross-dressing behavior is for the purpose of sexual excitement. Aside from cross-dressing, most individuals with Transvetic Fetishism do not have a history of childhood cross-gender behaviors. Males with presentation that meets full criteria for Gender Identity Disorder as well as Tranvestic Fetishism should be given both diagnoses. If gender dysphoria is present in an individual with Transvetic Fetishism but full criteria for Gender Identity Disorder are not met, the specifier With Gender Dysphoria can be used.

The category Gender Identity Disorder Not Otherwise specified can be used for individuals who have a gender identity problem with concurrent congenital intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).

In Schizophrenia, there may rarely be delusions of belonging to the other sex. Insistence by a person with Gender Identity Disorder that he or she is of the other sex is not considered a delusion, because what is invariably meant is that the person feels like a member of the other sex rather than truley believes that he or she is a member of the other sex. In very rare cases, however, Schizophrenia and severe Gender Identity Disorder may coexist. (all emphasis in the original.

Forget my past positions for a minute and read this with a fresh mind. Consider the implications of the above.

To avoid POV problems we need to include ALL of that text INCLUDING the part about transvestetic fetishism. The interested community of wikipedians has decided through a long consensus to keep these ideas in separate spaces. To use the DSM defintino we must do that.

A much more neutral, general, definition I found in a book. I beg you to just consider this passage as it stands, alone as a good definition of a transsexual....

Terminology is an importnat source of confusion "transsexualism" has many connotations, including "sex change,""trapped in the wrong body,""femininity"(in genetic males) or "masculinity" (in genetic females), and "cross-dressing." All I mean by "transsexualism" is the desire to become a member of the opposite sex. An adult with transsexualism is a "transsexual." These definitions say nothing about the motivation, apperance, or subsequent actions of the transsexual. They do not imply that the transsexual feels trapped in the wrong body, or that the transsexual even ultimately seeks sex reassignment.

The first objection someone will give is something like... "It says 'transsexualism" is the desire to become a member of the opposite sex,' this confuses sex with gender." Well here is where the difference between being generally transgendered and being a transsexual comes in. That one sentence all about says all that need to be said. The use of the first person by this writer would not be appropriate but a definition in this spirit may be better than the DSM one. Consider this definition, and the DSM defintion of these which is really better (more neutral to the variations that there are in transsexualism, More general etc.)? --Hfarmer 03:43, 10 January 2007 (UTC)

I don't even know where to begin with that paragraph. The terminology section already evident in this article is far better than anything proposed on this talk page, and I really don't see the need to open this particular can of worms. Rebecca 04:26, 10 January 2007 (UTC)
What are you talking about. This article is right now so bad that a transsexual from mexico (see above section was confused by it!--Hfarmer 15:49, 10 January 2007 (UTC)
Who? Where? I don't see this confusion clearly marked? It may be worth it to break it out into its own section so that it's more clear to see? I don't really feel comfortable commenting or supporting or arguing an assertion that the article is confusing without being able to read that other person's comments. --Puellanivis 19:41, 10 January 2007 (UTC) *sigh* found it, nevermind. I don't really see that she finds it confusing, but rather that the legal aspects of transsexualism does not cover Mexican laws governing transsexuals. --Puellanivis 19:42, 10 January 2007 (UTC)

Holly Black's comments:- Though the topic is controversial and consensus will likely never be reached, we could at least strive for factual accuracy. The subject section is entitled something like "The definition of Transsexualism according to the APA". That is highly problematic for several reasons. First the abbreviation APA is commonly understood to mean either the American Psychiatric Association or the American Psychological Association. Though these two fine organizations agree on many things there is one particular area in which they hold very different, one might say opposing views - and yes that area is transsexualism. Thus, to use the abbreviation APA in this context is confusing at best - in a subject area more beset by confusion than few others.

Secondly, neither APA defines it. Transsexualism is expressly defined by the WHO (World Health Organization http://www.who.int) in their various published manuals (plural) which each include the words "The International Classification of Diseases" in their title. I think few would disagree that the WHO outranks either APA, and even if it didn't, the United Nations Organization (http://un.int/ - of which the WHO is part) certainly does. Moreover the APA in its DSM does not even attempt to define transsexualism, but rather limits itself to GID which is related but not the same. APA-DSM-IV-TR GID (302.85) is, formally, an Axis I Mental Disorder, and expressly NOT an Axis II Personality Disorder. Contrariwise in the WHO-ICD-10 "Transsexualism" (and GID in Children), again formally, are "Disorder[s] of Adult Personality or Behaviour". Moreover, EVEN when present in children, ICD-GID is, formally, a disorder of [the child's] ADULT personality (emphasis added) and DSM-GID is NOT a Personality Disorder of ANY kind (emphasis added again). Thus, from the official (official) medical viewpoint GID and Transsexualism are in some sense opposites. I'm not proposing to resolve this disagreement, only to say it is a disservice to suggest that they are one and the same when the respected (respected rightly or more likely wrongly but respected nonetheless) authorities see it otherwise.

Since the professionals who write the definitions disagree among themselves it is not likely consensus will be found in Wikipedia. But hopefully it is not too much to ask for accurate reporting of the facts. It is especially important to be accurate when it is obvious at the outset that opinions will differ.

And while we are on the topic, it is plain wrong to suggest that Transsexualism and Transsexuality are the same thing. Rightly or, more likely, wrongly, Transsexualism is rigorously defined as a formally identified "Disease". In contrast Transsexuality is a colloquialism arguably pejorative. References: http://www.who.int/classifications/apps/icd/icd10online/ http://www.behavenet.com/capsules/disorders/prsnltydsrdr.htm -- written by Holly Black —The preceding unsigned comment was added by 69.226.228.239 (talk • contribs) 13:23, 26 March 2007 (UTC)

[edit] Perhaps we should rename this article "Gender Identity Disorder"?

Thinking about how to define "transsexualism" has gotten me thinking...should we use that word at all. Other than as a reference to an old defunct term for gender identity disorder. The ADA/WPATH definition is not a definition of transsexualism....but one of "gender identity disorder". I know rebecca thinks this article as it is is a perfect candidate for a featured article. :roll:. And so to just save her the breath I know you think everything I say sucks. What say the rest of you who are interested? --Hfarmer 15:49, 10 January 2007 (UTC)

As before I propose that we redo this article based on the version found on the so called "Simple english wikipedia version of transexualism". I just saw this today. Note that it's last update is in june 2006. These other set of people thought basically as I did for this version of wikipedia. An article like that one but a little bit longer would be better. Breaking this information into easier to swallow bites. Perhaps adding a shortened paraphrasing of the DSM definiton of GID. --Hfarmer 15:58, 10 January 2007 (UTC)

I really don't see that article as having very much content at all. And starting from the Simple English version, would basically set the article back more than anything that it would actually provide. If you feel that the article needs to be restructured, then things can be moved around and restructured without having to redo the whole page. The Simple English version is also quite broad, generic and does not note exceptions, and disputes at all. It does not recognize that some people object to transsexuals being classified under the umbrella of transgender, and it also presents a view that transsexuals must require/plan for surgery in order to be transsexual. It also says that transgendered individuals are those where their gender identity does not match with their physical sex. This is not accurate as crossdressers are transgendered, but their gender identity is reasonably in line with their body, they just feel a comfort in expressing different gender roles, but their gender identity is in no way in crisis.
I think you have some good ideas for improving the article, but a slash-and-burn tactic will not generate much support. --Puellanivis 19:52, 10 January 2007 (UTC)

[edit] Adding Smith vs. City of Salem to Employment issues sections

Recently, the court case of Smith vs. Salem took place in the sixth circuit court. This case used a supreme court ruling to extend the definition of sex into the realm of gender, and with it include transgender as a protected class. I think this has merit for inclusion in the employment issues section. What do you think? Link to the opinion:[1]. This is another useful document: [2] LexieM 01:54, 6 February 2007 (UTC)

it's an interesting read, and is actually already covered by Legal aspects of transsexualism. Reading the brief, it does not actually seem as if they have extended any recognition to transsexuals as their target gender, but rather that discriminating against someone for not following the stereotypes provided for their gender is inappropriate, and the document refers to Smith throughout as a "male", albeit as an identified "transsexual", and "medically diagnosed with Gender Identity Disorder". Now, what this does do is create a rock and a hard place for employers (who are subject to Title VII) regarding dismissing a transsexual. The employer cannot dismiss a transsexual as their original gender for expressing themselves as their gender of identity, but it's pretty certain that they wouldn't be able to dismiss a transsexual as their gender of identity, because if they had the job before, then they were qualified for the job, and the only thing that has changed is their sex. Thus, if a employer were to attempt to dismiss them simply for assuming the new gender, they would be by definition firing someone based on their sex. So, I rather see this decision as a boon to transgendered people who are not intending on altering their legal gender, and as protection for transgendered people who are intending on changing their legal gender, but have yet to do so. In many cases though, the courts rulings on what a person's legal gender is can vary from state to state, from courthouse to courthouse and from judge to judge. --Puellanivis 18:12, 6 February 2007 (UTC)
The Legal aspects of transsexualism article should be liked to in the Employment Issues section as it contains much more information. But do you think we should make specific reference to Smith vs. Salem in this article because of its importance as the only decision on the US federal level that possibly offers protection? LexieM 01:08, 7 February 2007 (UTC)
That sounds certainly reasonable. Please feel free to work up a short mention of the protection that it offers us, and then either post it here, or post it into the article. You can leave it with "for more information see Legal aspects of transsexualism" or something like that. I think it would certainly be helpful information. --Puellanivis 07:21, 7 February 2007 (UTC)

[edit] the "Coming Out" Section

A noticable problem with the current page is the "Coming Out" section, which is currently empty. Although there is already a page on coming out it deals only briefly with transsexuals.

I suggest this section include:

  • Coming out Process
  • Stages of Coming out
    • To Health Care Proffessionals
    • To Family
    • To Friends / Socially
    • To employers / At work
  • Legal steps in coming out
    • Changing name
    • Changing identity documents
    • Legal recognition

Although now that i look at my own list, it may require it's own article, with references to transsexualism, Legal_aspects_of_transsexualism, and external references.

Lwollert 11:22, 12 February 2007 (UTC)

[edit] Genetic level sex change, a possibility?

This discussion has been moved to my talk page - If there are any other comments, please put them there. This is because the discussion had little to do with the article, as pointed out by Jokestress and Wwagner. Thanks especially to Puellanivis for her contributions.

[edit] Redundant link

I believe that the [http:/transsexual.org Transsexuality] page is linked twice: once as "transsexuality" and once as "what is transsexuality". Should we remove the latter? (Last of the external links list_ Lwollert 01:51, 15 February 2007 (UTC)

[edit] History of transsexuality

Is there any interest in making a section on the ancient and recent history of transsexuality? I.E.

  • Certain ancient greecian temples where men dressed and acted exclusively as women
  • Eunuch culture and transsexuality
  • Berdache culture in North america
  • Harry Benjamin and his contribution to the modern treatment and diagnosis of transsexuals
  • the near-infamous Christine Jorgensen who brought transsexualism to popular cultre in the united states
  • Renee Richards' challenge against United States Tennis Association in 1976, which helped bring about anti-discrimination rulings, and introduced transsexual women into sport
  • The recent ruling, pre-Athens Olympics, by the IOC that transsexuals could compete in the olympics
  • the various other legal milestones in regards to marriage, adoption, and the like.

Cheers, Lwollert 02:01, 15 February 2007 (UTC)

Legal milestones may be more appropriate for the Legal aspects of transsexualism. As far as the Olympics is concerned, the full accurate history should be given that they attempted to identify gender based on genetics, and thus invalidated a number of women who are XY female (not just transsexuals). The recent ruling that changed this was that a woman would be allowed to compete in the women's competitions as long as her hormone levels were feminine, and not masculine, thus determining that "doping" by internal production of steroids in the female competitions is against the rules. This allows transsexuals essentially as a side-effect to allowing intersexed females, but it is not sufficient for a person to simply identify as transexual, they need to be physically appropriate to the competition. --Puellanivis 02:13, 15 February 2007 (UTC)
Fair enough; Any comments on the other suggestions, though?
Link for sport in the UK; Includes IOC regulations [3]. Interestingly, www.olympic.org doesn't have the guidelines set out there, merely an explanatory statement. Apparently it's been called the "Stockholm Consensus". And although the consideration was made in light of the review of Gender testing procedures, the consensus on transsexuals took place four years after the scrapping of the old tests [4] and is specifically in regards to transsexuals.
Cheers, Lwollert 00:14, 21 February 2007 (UTC)

[edit] Verification - Terminology

My proposition is that the following section from "Terminology" should be changed.

"Harry Benjamin agreed with German sexologist Magnus Hirschfeld [2]that transsexuals were a form of neurological intersex. [3]Hirschfeld coined the terms the terms "Transvestite" and "Transsexual, and in 1930 supervised the first known sex reassignment surgery on Lili Elbe [4]of Denmark."

Just double-checking my facts, but AFAIK Hirschfield coined did not coin either "transvestite" or "transsexual" - The former Coined the term in German - "Die Transvestitien" (1910) in his seminal work on the issue, and was describing what is now known as Transsexuals. The term was translated into English and used to talk about Gender dysphoria as well as what we now know as Transvestic fetishism.

Harry Benjamin actually coined the term "Transsexual" in his work, (Benjamin, 1953) which culminated with "The Transsexual Phenomenon" in 1966. Gender Dysphoria as a term was not used until about the 1970s, and was used as a term to encompass a wide range of individuals with gender discomfort. (Fisk, 1974, Laub and Fisk, 1974)

"Gender Identity Disorder" Was a term created in the DSM-III in regards to transsexuals, and the categories were "GID/Childrem Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Notably, this did not address Late-onset transsexualism, where patients may not have had symptoms as children. Interestingly, in the major revision of the DSM, DSM-III-R, It was placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above

In the DSM-IV-TR, the current version, GID is placed in the category of Sexual Disorders, with the subcategory of Gender Identity Disorders. This is perhaps distasteful to transsexual people, as it is right next to transvestitic fetishism, Pedophilia, Fetishism, Orgasmic, Arousal and Erection disorders, and other similar categories. The disorder names were changed to "Gender Identity Disorder in Children", "Gender Identity Disorder in Adolescents or Adults", and "Gender Identity Disorder NOS".

Additionally, Both the DSM-III and DSM-IV differentiate based on sexual attraction. In the DM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion (Pauly, 1992). Currently the terms "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither" are used in the DSM-IV-TR.

References:

  • American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders 3rd ed. A.P.A.: Washington D.C.
  • American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders 3rd ed., revised A.P.A.: Washington D.C.
  • Benjamin, H. (1953). Transvestism and Transsexualism. International Journal of Sexlogy, 7, 12-14
  • Benjamin, H. (1966). The Transsexual Phenomenon. Julian Press: New York
  • Fisk, N (1974) Gender Dysphoria Syndrome. In D. Laub & P. Gandy (Eds.) Proceedings of the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome. Ann Harbour: Edwards Brothers, 7-14
  • Laub, D. and Fisk, N. (1974) A rehabilitation program for gender dysphoria syndrome by surgical sex change. Plastics and reconstructive surgery, 53, 338-403
  • Pauly, I. (1992) Terminology and Classification of Gender Identity Disorders. Journal od psychology & human sexuality, volume 5, number 4, 1992

Cheers, Lwollert 21:09, 21 February 2007 (UTC)

[edit] Both a Notes and References section?

Was wondering if these two sections should be merged into one? Is there a dominant, or preferred, style occuring in this article? ZueJay (talk) 03:46, 5 March 2007 (UTC)

Oh hey, I'm keeping out of this one!! ;-) - Alison☺ 03:49, 5 March 2007 (UTC)
Ack! None of that! I was just mostly curious as to why there were the two sections? Usually there is only one or the other, isn't there? ZueJay (talk) 03:57, 5 March 2007 (UTC)
It shouldn't really matter - I've often seen both in an article and it usually follows this format. References relate directly to points in the text and 'Notes' or 'Further reading' gives general reference material to the topic at hand. Merge if you like - I don't really mind. If you use {{Reflist}} and {{Sourcesstart}} / {{Sourcesend}}, they can merge really nicely. - Alison☺ 06:57, 5 March 2007 (UTC)
Okay, that makes more sense now. It looks like the current "References" section should be "Further reading" and the current "Notes" section should be "References." Does that make sense? My thought here is that the current "References" is not direclty cited in the text, but the "Notes" section is; my head goes "The ref tag is used, it should be under a heading of 'References' whereas no tag then it probably should be 'Notes' or 'Further reading.'" 'S-alright? ZueJay (talk) 07:24, 5 March 2007 (UTC)
Sounds about right. Lwollert 20:22, 6 March 2007 (UTC)
Changed the headers: Notes --> References, and References --> Bibliography. Bibliography is more formal and probably more reflective of how those sources were actually used for information contained within the article (but not directly cited). ZueJay (talk) 18:13, 7 March 2007 (UTC)
Well done! Looks lots better - Alison☺ 18:41, 7 March 2007 (UTC)
I didn't even do anything ;) ZueJay (talk) 19:13, 7 March 2007 (UTC)

[edit] Merge into Sexual Reassignment Therapy

The idea behind this article is primarily as a overview. If there are details in the SRT section that go maybe a bit too in depth, then certainly, we can make sure that they're in the SRT article, and then remove them here, but it would not support the current trend of this article to just move all the SRT information into that article, and then remove it from here.

From what I've seen in general from previous editors' opinions is that we would like to have this article stay fairly broad but somewhat deep, to give a good accurate overview of Transsexuals in all. This means no "Go read this other article" sections. If this means a duplication of information on this page as well as the main article page, then that's acceptable, as long as the information is quite important. I think rather than seeing a direct merge, I'd like to see the information of this article merged into the SRT article, and then appropriate edits made here secondarily. --Puellanivis 06:29, 5 March 2007 (UTC)

So, I made my original comments on the reason I proposed the merge, and how I would consider merging, on the template's linked discussion page at Talk:Sex reassignment therapy. My intent is much as you stated above:

I'm proposing this merger because these sections claim the same name, yet aren't discussing the same things even though it appears they should be. Through a quick overview, it seems most appropriate to merge the Transsexualism#Sex reassignment therapy section into this primary article; of course, leaving in place appropriate "quick" descriptions on the Transsexualism article. Let me know if I'm off my rocker. Thanks.

However, we should only discuss this in one place, so here or there? ZueJay (talk) 06:52, 5 March 2007 (UTC)
Oh... chalk that up to me not reading... *laugh* Ok, I'm in agreement then. --Puellanivis 06:54, 6 March 2007 (UTC)
I agree with the partial merge proposal; the current "SRT" section is long, uncited, has some POV issues and wanders a long way from SRT in some places. Certainly a link to Sex reassignment therapy and Transitioning (transgender) would be useful (although the latter needs a lot of editing/addition to be useful, and is subject to a merge proposal of it's own)
Cheers, Lwollert 09:17, 6 March 2007 (UTC)
 ;) I gotcha!
Certainly I have stumbled across a lot of not, or poorly, linked articles with lacks of cites, etc. in the T-category lately. I wonder if part of the problem stems from determining the appropriate name (naming convention) for some of the articles. Even in the LGBT cats at large, this is increasingly an issue; last night I proposed, essentially, a group merge for a bunch of GLAAD Media Awards.
Anyway, It seems like folks sound okay with this. I'll start sifting something through my sandbox to merge the section into the article. Thanks for the feedback - it doesn't always occur. ZueJay (talk) 16:06, 6 March 2007 (UTC)
PS - I'll still wait the min recommended five days before actually significantly showing the merge in the article in case there are more editors wanting to supply feedback. ZueJay (talk)

Merged what was sitting in my sandbox, the majority of which I reviewed. However, I have limited knowledge of these topics and how to correctly phrase certain things. Please, please, please review it carefully. Also, there is a lack of information in this newly merged article with regards to intersex individuals (right there I probably made a grammer gaff!); need to modify to better include.
We also now need to pare the SRT portion of this article down to eliminate the duplication of information. ZueJay (talk) 19:08, 28 March 2007 (UTC)

[edit] An important point...

I would like to see some reference to the viewpoint brought up by, for example, Kate Bornstein in "Gender Outlaw" which is that transsexual people may not always feel the necessity for sex reassignment operations (especially, conscious of their possible complications and general uncertainty of the outcome) or indeed strongly dislike their body/genitals (except perhaps for the reason that society does not accept their body to be of the sex or gender that they feel they represent). She proposes the division to pre- and postoperative transsexuals be given up. English is not my first language and I am not certain I know enough on the topic to do this myself, but I'm hoping perhaps there is someone else interested in this aspect and willing to contribute? Shadowcrow 20:50, 11 March 2007 (UTC)

Hmmm.... Kate bornstein is an interesting writer, and she does have some strong opinions.
Part of her argument is that there should be no male/female gender division, and that transsexuals are giving into medical and social structures when they ascribe to the medical process.
The problem is, to subscribe to the medical process, and be diagnosed as transsexuals, they need to have strong cross-gender identification, not just "agender" identification - and additionally, they have to desire surgery, else they don't fit the medical defenition of transsexualism (as in the DSM-IV-TR or ICD-10, anyway).
I think there should be a small section on this, but it does not represent the majority of transsexuals. A more appropriate place to put it would perhaps be transgender rather than transsexualism.
As a side-note, her (Kate Bornstein's} theory is quite similar (perhaps disturbingly so) to Janice Raymond's hypothesis about transsexualism. Both are strongly criticised by some, including Patrick Califia, who I've referenced on a couple of pages now.
Cheers! Lauren♫/∆ 04:20, 12 March 2007 (UTC)
I believe there already exists the prefix "non-op" to counter "pre-op" and "post-op". Maybe this is mostly restricted to areas where transsexuality is well accepted, like Seattle. But I've already heard it fairly commonly in use. I personally couldn't imagine being non-op... and all of my non-trans female friends probably would agree with me that I'm not "raping" their bodies as Janice Raymond would put it... to them it's entirely naturally that I'm female. I would however argue that there are transsexuals out there who this would describe, but then there are men out there who physically rape women. As with anything, categorizing any group of people and giving a generic reason for their motives, just isn't appropriate, or justified. Sorry to get on a person-ish rant here. But I really just wanted to point out that there are non-op transsexuals out there. And they receive the same treatment all of the other transsexuals do. --Puellanivis 05:57, 12 March 2007 (UTC)
My apologies if I left out aknowledging the non-op transsexuals - I certainly know they exist. I don't dispute that these people are transsexual, or should be labeled otherwise - instead I hoped to include them (although I seem to have failed :) ). My main point in relation to them is that they don't fit the medical definition if they don't desire surgery - but you can be non-op and still desire surgery, or non-op and not desire surgery.
Absolutely non-op individuals need and hopefully recieve medical support - usually under a slightly different diagnosis. And I support them in their right to decide how they want to live, whether or not I would make that choice in the first place.
Most of my objection was supposed to be aimed at the argument by Bornstein that anyone who wants an operation is giving in to a medical diagnosis, and all transsexuals should instead be "gender outlaws" - that none of us should want bottom surgery, and we should all be non-op. It's that that I object to and believe is a view held by a minority of transsexuals, but perhaps describes more people who are transgendered.
Sorry for any accidental offense. Cheers! Lauren♫/∆ 05:24, 26 March 2007 (UTC)
Oh, I understand better now. That makes more sense. ... Yeah, I just can't agree with that at all. I'm sorry, but I have more than just "preference" for why I want "bottom surgery". Well, first of all, it would be nice to be able to stop taking anti-androgens. Second of all, it's extremely uncomfortable for me. I know an FTM to was talking to the list about how he was very happy to be getting his top surgery done, because during the summers it caused him a great deal of discomfort to bind himself during the summer. I can typically identify with this issue, but instead of being top issues, it's bottom issues. If I'm uncomfortable with something, I'm going to get it taken care of, and I'm not going to let some ideological reasoning stop me from getting that surgery. My ideological reasons don't confront me in the shower, and on the toilet, and it doesn't rub and chafe me in the summer. I can work with the process and still seek to have issues addressed for a better process for following people. I don't expect the world to be perfect for me, but I do hope that I leave it better for those who follow than I had it. --Puellanivis 06:15, 26 March 2007 (UTC)
Hear, Hear, Easy Access to Surgery To Eventually Reduce Chafing! (Tounge-in cheek, I agree totally.) Cheers! Lauren♫/∆ 00:05, 2 April 2007 (UTC)

[edit] Citation dispute

There is an error in this article. In her latest interview, Renee Richards denies any regret regarding her SRS. From the Reuter's article on Feb 18 2007 (written by Belinda Goldsmith) "Richards, now 72 and without a partner, said she does not regret the sex change operation at the age of 40 -- although she might have liked to have gone through the process a bit earlier -- but she does have misgivings about her notoriety. "I made the fateful decision to go and fight the legal battle to be able to play as a woman and stay in the public eye and become this symbol," Richards, an ophthalmologist, told Reuters in an interview in her Manhattan offices. "I could have gone back to my office and just carried on with my life and the notoriety would have died down. I would have been able to resume the semblance of a normal life. I could have lived a more private life but I chose not to. "I have misgivings about that. I am nostalgic about what would have happened if I had done it the other way," said the 6-foot-2-inch tall Richards with an unmistakable air of sadness as she folds her man-sized hands in her lap." This aspect of the article should be corrected

Certainly Renee Richards is quoted in the lynn connway site as experiencing regret, and cites a newspaper article. If you read her book, Renee certainly had a lot of co-morbidities when she transitioned, including fairly severe depression.
I think if you can cite the newspaper article (a link, perhaps?) we sould definately change the article.
Cheers! Lauren♫/∆ 07:25, 21 March 2007 (UTC)
I believe that Dr. Richards has published a second book - I'll try and get my hands on it ( Richards, Renee & John Ames (2007), No Way Renee: The Second Half of My Notorious Life (Hardcover), Simon & Schuster, ISBN 978-0743290135 )

[edit] Guardian article

The in-text citations from the guardian article don't reference the study itself, and furthermore some of the quotations are taken out of context. ( The original report's finding is avilable here: http://www.arif.bham.ac.uk/requests/g/genderreass.htm#3 )

Note that the report says that the uncertainties are too large to form a conclusion, it certainly does NOT say that there is no evidence ( in contrast to the guardian article ). It also states:

"The points above, by raising significant problems in the conduct of much of the research claiming to show that gender reassignment surgery is beneficial, suggests that the true conclusion from the available research is that we genuinely cannot be certain about what its effects are. A systematic review could help reduce this uncertainty, but because of the flawed nature of the majority of the research it is likely that the only way to reduce the level of uncertainty is to undertake more research using more rigorous designs with a control group, ideally randomly assigned, and blind independent assessment of outcomes (Abramowitz SI, 1986)."

In other words, the report simply says the research on the matter is insufficient to form a conclusion. It certainly doesn't say that there has been no signs suggesting it is beneficial ( which is what the wiki article currently claims ).

Furthermore, the review itself comes with a disclaimer: " The information is only a very brief summary of that available at the time. It was primarily designed to give readers a starting point to consider research evidence in a particular area. Readers should not use the comments made in isolation and should read the literature suggested. Readers should also be aware that more appropriate evidence may have become available since the request was undertaken. ARIF does not routinely update the advice on these pages."

ALl in all, given the above discrepancies between the guardian article and the disclaimer provided in the review, I really don't think it is a good source and basing almost half the section on it is probably not justified. I would much rather see a reference to a more official statement made by an official organisation. The Guardian is a newspaper, known to be sensationalist, and I think it is fairly obvious that the current bit that is in there is probably not a very good representation of the general opinions of experts in the field. I'd say it should go. J.Ring 11:56, 2 April 2007 (UTC)

Hmm. It does sem a bit misplaced, doesn't it?
I think a more accurate description of effectiveness would be that there is insufficient evidence to state clearly that there is a benefit, however current studies show some positive outcomes and possible reduction in healthcare costs after SRS/SAS/GRS (pick your TLA of choice). Additionally, social indicators showed an increase in social function, and psychoneurotic index scores show lowered levels of anxiety. Methodologicaly, however, the studies thus far are unsuitable to giving precice estimates of benefit. (The Wessex Institute for Health Research and Development. Surgical gender reassignment for male to female transsexual people. 1998:25. Southampton: Wessex Institute for Health Research and Development [5])
Shall we replace it? (the above link is a structured review artice, so level 2 or 3 evidence)
Cheers! Lauren♫/∆ 23:45, 2 April 2007 (UTC)
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