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[Consul]

Consul,
You suggest that you 'don't know' the causes of transsexuality' but you 'bet the innate gender model of gender identity is incorrect'. Bearing in mind your emphasis on precision in definitive categories, this is extremely vague. Also, you suggest that it is up to scientists to find out the causes? What about personal testimony as an aspect of qualitative research, recognised as of value in evidenced based psychology and psychiatry?

Actually, the main reason for my "bet" is that the (innate) gender-identity model seems conceptually ill-defined to me; so I see a good a priori reason to reject it.

Only die-hard behaviorists would deny the value of personal testimony in the form of introspective reports in psychology/psychiatry, but the "lived experience" (trans)gender theorists appeal to is anything the supreme epistemic authority in this matter.

I know that you argue that you are a reductive materialist, but why? Are there not any weaknesses to such an approach? What about the role of participant observer in research? Are there not limitations of reductive materialism? Would you go as far as to say that in considering the value of medicine that the experience of the effects and side-effects of the person taking it? To what extent can science be detached and value free?

Reductive materialism without any consideration of values is a rather one dimensional approach. In spite of your claim to recognise the bio-psychosocial model, this does not seem evident in your approach and thinking, as it is extremely selective and does not incorporate multidisciplinary dialogue and blending.

(There is nothing "multidisciplinary" about the very definition of sex (the sexes), because it's solely a matter of biology.)

As a purely ontological position, reductive materialism doesn't impose any methodological constraints on psychology or sociology (as long as they stay methodologically naturalistic/non-supernaturalistic). It doesn't say "Don't play with the neighbours' children!", it is not to be equated with anti-introspectionist behaviorism, and it isn't wedded to strict "positivism" in the philosophy of social science either—where there is an ongoing debate over the notorious opposition of explaining and understanding, and the corresponding opposition of "hard" or "positivistic" (stricly empirical/nomological/explanative/quantitative) social science and "soft" or "antipositivistic" (hermeneutical/interpretative/qualitative) social science.

[Consul]

Only die-hard behaviorists would deny the value of personal testimony in the form of introspective reports in psychology/psychiatry, but the "lived experience" (trans)gender theorists appeal to is anything [but] the supreme epistemic authority in this matter.

[Lagayascienza]

This thread is bogged down in a dispute about terminology that does not advance anyone’s understanding of what is at stake.

There is nothing delusional about a boy with gender dysphoria feeling that he should be a girl despite his/her knowing he/she has a penis. Calling it delusional is tantamount to saying that gender dysphoria should again be again listed in the DSM as a psychosexual disorder and that it should, therefore, be treated with psychotherapy. The john/Joan case demonstrated that this is the real delusion and not the person's feeling of what gender they should be. No amount of psychotherapy will help because it does not address the cause of gender dysphoria. Neurobiological research into gender dysphoria has demonstrated “distinct gray matter volume and brain activation and connectivity differences" in people suffering from gender dysphoria when compared to controls; and this "leads to the concept of brain gender” Thus, it is likely that physical differences in the brain account for the feeling gender dysphorics have that they are the wrong sex.

If this is so, then there are two ways gender dysphoria could potentially be treated. 1. Gender reassignment with hormones, and surgery if surgery is what the person wants. 2. Make neurosurgical changes in the brain that correct the neurological differences that cause gender dysphoria. Clearly, 2. is not yet an option and won’t be until far into the unforeseeable future, if at all. And even if it were possible, a gender dysphoric person with male genitalia may want to continue to feel, as they always have, that they are female despite their genitalia. In which case, again, gender reassignment may be the bet option.

Everyone knows what the term “gender identity” means. It means the sense one has that one is a certain gender whatever genitalia one has. Gender identity is not about what genitals one has. It is about what gender one feels oneself to be, and the feeling of being one or the other gender is likely caused by differences in neuroanatomy.

[Consul]

OMG, you re displaying all the poetry of a brick. You don't have to take everything literally, weighing all words against scientific terms. You can look behind the words to try to understand a speaker's or writer's intent.

When a boy claims he is a girl, he is not being delusional. He is not saying that he is unaware of his penis or that that penises are attached to boys. That seems to be your interpretation. Such a child would clearly describing how he feels inside, his sense of estrangement from masculine things and leanings towards the feminine. That happens with some gays too, but it seems that some young people take their discomfort in their expected gender role more to heart than others. For some, it is deeply internalised. History shows that changing transpeople via cognitive therapy does not work, so that would suggest that the dysphoria is "innate", yes?

Gender dysphoria can as well be caused by negative life experiences. A teenage girl sexually harassed by boys might start to hate her female body as an object of sexual attraction, but not because she is truly transsexual. For she just desires to be left alone. A teenage girl falling in love with another girl might wish to be a boy, because her religious parents told her that homosexuality is a sin.

Okay, I agree that when a 10-year-old boy claims he's a girl, he arguably doesn't mean that he has egg-filled ovaries. His intuitive conception of girlhood is not based on biological knowledge of gonads & gametes. So what is it based on? It is based on his everyday perception of manifest sex differences (appearance and behavior) between boys and girls, and on how they are treated differently by society (under the control of subconscious sex-differential social norms or expectations).

Now, here's an important fact:

"One can identify with a group without being a member."

(Byrne, Alex. Trouble with Gender. Cambridge, UK: Polity, 2024. p. 175)

It's one thing for a "transboy" to identify with girls, and another for him to identify as a girl. He may utter the sentence "I am a girl"; but if this is just an expression of his emotional identification (association/affiliation) with girls or "all things feminine", then it's not a delusion.

[Pattern-chaser]

I'm a reductive materialist, so I do think all mental phenomena are neural phenomena.

No, you are a Tamarian, communicating only by quotes from sacred texts:

When Dathon speaks again, referring to what sounds like a battle plan, Picard suddenly understands that the Tamarians communicate by citing example – by metaphor.

[Fried Egg]

Everyone knows what the term “gender identity” means. It means the sense one has that one is a certain gender whatever genitalia one has. Gender identity is not about what genitals one has. It is about what gender one feels oneself to be, and the feeling of being one or the other gender is likely caused by differences in neuroanatomy.

It seems clear to me that there are innate gender differences in terms of our behaviour but it was not clear to me whether this included our sense of our own gender identity (hence why I started this thread). But it seems clear, at least in certain cases, that some people seem to have it. I was not aware of this in myself and I do wonder whether everyone has it? At least it seems hard to separate it from what we learn about our gender from society.

There is nothing delusional about a boy with gender dysphoria feeling that he should be a girl despite his/her knowing he/she has a penis. Calling it delusional is tantamount to saying that gender dysphoria should again be again listed in the DSM as a psychosexual disorder and that it should, therefore, be treated with psychotherapy. The john/Joan case demonstrated that this is the real delusion and not the person's feeling of what gender they should be. No amount of psychotherapy will help because it does not address the cause of gender dysphoria. Neurobiological research into gender dysphoria has demonstrated “distinct gray matter volume and brain activation and connectivity differences" in people suffering from gender dysphoria when compared to controls; and this "leads to the concept of brain gender” Thus, it is likely that physical differences in the brain account for the feeling gender dysphorics have that they are the wrong sex.

If this is so, then there are two ways gender dysphoria could potentially be treated. 1. Gender reassignment with hormones, and surgery if surgery is what the person wants. 2. Make neurosurgical changes in the brain that correct the neurological differences that cause gender dysphoria. Clearly, 2. is not yet an option and won’t be until far into the unforeseeable future, if at all. And even if it were possible, a gender dysphoric person with male genitalia may want to continue to feel, as they always have, that they are female despite their genitalia. In which case, again, gender reassignment may be the bet option.

I think that most people can agree that there are genuine cases of gender dysphoria and that helping such people live as the opposite sex might be the best way to help them. But I think that what has made this issue so contentious in recent times are changes to medical best practices and the law (driven by activists) that are going too far. Affirmative care seems to be about dispensing with the rigorous and careful process that ensures that misdiagnosis aren't made (and permanent life changing treatments aren't embarked upon prematurely). The whistle-blowers at the Tavistock gender clinic are testament to this going on. So are the "WPATH files" that show that an organisation that should be purely scientific and medical has become dominated by activists.

One of the biggest concerns here is how little effort some of these clinics/organisations make to follow up on the long term effectiveness/success of the treatments that have been carried out to transition their patients. Some of those that transitioned and later sought to de-transition remarked on how they were just dumped as soon as their treatment was complete.

Like most things in life, it is about finding the correct balance and society tends to swing first too far one way and then too far another like a pendulum.

[Sy Borg]

Now, here's an important fact:

"One can identify with a group without being a member."

(Byrne, Alex. Trouble with Gender. Cambridge, UK: Polity, 2024. p. 175)

It's one thing for a "transboy" to identify with girls, and another for him to identify as a girl. He may utter the sentence "I am a girl"; but if this is just an expression of his emotional identification (association/affiliation) with girls or "all things feminine", then it's not a delusion.

It's true that one can identify without being a member but it seems that is not enough for transpeople. I suppose, they might feel like the opposite sex but, if they stay put, everyone will continue to treat them as their birth gender.

What you don't want to do is discourage truly trans people so that they form relationships and end up up causing distress when they can't keep up the act.

[Lagayascienza]

Everyone knows what the term “gender identity” means. It means the sense one has that one is a certain gender whatever genitalia one has. Gender identity is not about what genitals one has. It is about what gender one feels oneself to be, and the feeling of being one or the other gender is likely caused by differences in neuroanatomy.

It seems clear to me that there are innate gender differences in terms of our behaviour but it was not clear to me whether this included our sense of our own gender identity (hence why I started this thread). But it seems clear, at least in certain cases, that some people seem to have it. I was not aware of this in myself and I do wonder whether everyone has it? At least it seems hard to separate it from what we learn about our gender from society.

There is nothing delusional about a boy with gender dysphoria feeling that he should be a girl despite his/her knowing he/she has a penis. Calling it delusional is tantamount to saying that gender dysphoria should again be again listed in the DSM as a psychosexual disorder and that it should, therefore, be treated with psychotherapy. The john/Joan case demonstrated that this is the real delusion and not the person's feeling of what gender they should be. No amount of psychotherapy will help because it does not address the cause of gender dysphoria. Neurobiological research into gender dysphoria has demonstrated “distinct gray matter volume and brain activation and connectivity differences" in people suffering from gender dysphoria when compared to controls; and this "leads to the concept of brain gender” Thus, it is likely that physical differences in the brain account for the feeling gender dysphorics have that they are the wrong sex.

If this is so, then there are two ways gender dysphoria could potentially be treated. 1. Gender reassignment with hormones, and surgery if surgery is what the person wants. 2. Make neurosurgical changes in the brain that correct the neurological differences that cause gender dysphoria. Clearly, 2. is not yet an option and won’t be until far into the unforeseeable future, if at all. And even if it were possible, a gender dysphoric person with male genitalia may want to continue to feel, as they always have, that they are female despite their genitalia. In which case, again, gender reassignment may be the bet option.

I think that most people can agree that there are genuine cases of gender dysphoria and that helping such people live as the opposite sex might be the best way to help them. But I think that what has made this issue so contentious in recent times are changes to medical best practices and the law (driven by activists) that are going too far. Affirmative care seems to be about dispensing with the rigorous and careful process that ensures that misdiagnosis aren't made (and permanent life changing treatments aren't embarked upon prematurely). The whistle-blowers at the Tavistock gender clinic are testament to this going on. So are the "WPATH files" that show that an organisation that should be purely scientific and medical has become dominated by activists.

One of the biggest concerns here is how little effort some of these clinics/organisations make to follow up on the long term effectiveness/success of the treatments that have been carried out to transition their patients. Some of those that transitioned and later sought to de-transition remarked on how they were just dumped as soon as their treatment was complete.

Like most things in life, it is about finding the correct balance and society tends to swing first too far one way and then too far another like a pendulum.

Agree with pretty much all of that, Fried Egg.

I always make an effort to read up on scientific research because, on sensitive issues like this, it's easy to go off half-cocked.

The excesses you and others have alluded to I blame on pernicious post-modernism which seems to have taken over our universities. I started a thread here about it called POSTMODERNISM AND IT"S DISCONTENTS in the Philosophy of the Arts section and there were some interesting responses.

[Consul]

This thread is bogged down in a dispute about terminology that does not advance anyone’s understanding of what is at stake.

Terminology matters a lot in philosophy and science, and critical conceptual analysis does advance everyone's understanding! In gender (identity) discourse terminology is a mess!

There is nothing delusional about a boy with gender dysphoria feeling that he should be a girl despite his/her knowing he/she has a penis. Calling it delusional is tantamount to saying that gender dysphoria should again be again listed in the DSM as a psychosexual disorder and that it should, therefore, be treated with psychotherapy.

For your information: Gender dysphoria is still listed in the DSM-5 as a mental disorder!

"Gender dysphoria in adolescents and adults is classified by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as a mental disorder characterized by unhappiness with one’s biological sex or its usual gender role and with the desire for the body and role of the opposite sex."

("Gender Dysphoria in Adolescents and Adults," in Mental Health and Mental Disorders: An Encyclopedia of Conditions, Treatments, and Well-Being, Vol. 2: F-P, edited by Len Sperry. Santa Barbara, CA: Greenwood, 2016. p. 501)

"The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures."

Quelle: https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC8640116/

The john/Joan case demonstrated that this is the real delusion and not the person's feeling of what gender they should be. No amount of psychotherapy will help because it does not address the cause of gender dysphoria.

You're questionably presupposing that there is such a thing as the (one) cause of gender dysphoria (as postulated by the innate gender-identity model).

Neurobiological research into gender dysphoria has demonstrated “distinct gray matter volume and brain activation and connectivity differences" in people suffering from gender dysphoria when compared to controls; and this "leads to the concept of brain gender” Thus, it is likely that physical differences in the brain account for the feeling gender dysphorics have that they are the wrong sex.

Gender dysphoria is a mental state; and if mental states are neural states, then it is trivially true that there are certain neurological differences between the brain of a gender-dysphoric person and the brain of a non-gender-dysphoric person. However, it doesn't follow that gender dysphoria is innate or hardwired in the brains of gender-dysphorics.

Everyone knows what the term “gender identity” means.

LOL!!!
Even gender theorists now admit that…

"…there is no one thing that answers to the name "gender" (or, for that matter, to the name "gender identity")."

(Briggs, R. A., and B. R. George. What Even Is Gender? New York: Routledge, 2023. p. 2)

It means the sense one has that one is a certain gender whatever genitalia one has. Gender identity is not about what genitals one has. It is about what gender one feels oneself to be, and the feeling of being one or the other gender is likely caused by differences in neuroanatomy.

What exactly is a gender, if it's not one of the two sexes?
What exactly is a sense of gender, if it's not awareness/knowledge of one's sex?
You call gender identity a feeling, but what exactly is "the feeling of being one or the other gender"? When a transwoman says "I feel that I am a woman", what exactly does "to feel" mean here?

Among the meanings of "to feel" mentioned in the Oxford Dictionary of English are "to perceive mentally, become aware of", "to have the sensation of being (what is predicated);…to regard oneself as", "to believe, think, hold as an opinion", "to apprehend or recognize the truth of (something) on grounds not distinctly perceived; to have an emotional conviction of (a fact)". – So, basically, a feeling can be a belief, and it can be knowledge.

A man can regard himself as a woman, believe or think that he is a woman, be convinced, or be certain that he is a woman; but a man cannot perceive, be aware, apprehend, or recognize that he is a woman, since this presupposes being a woman.

Anyway, if gender identity is gender (self-)belief or gender (self-)knowledge, why not dump the inappropriate and confusing term "gender identity", especially as it makes no sense to call a belief or knowledge an identity?!

[Lagayascienza]

I did not say that it was no longer listed in the DSM-5. I said it was no longer listed as a psych-sexual “disorder”. The diagnosis was renamed from “gender identity disorder” to ‘gender dysphoria’. The word disorder is no longer used. And for a diagnosis there must be mental distress caused by the dysphoria. The DSM also uses the term “gender identity”. The following is from the DSM website:

The term “transgender” refers to a person whose sex assigned at birth (i.e. the sex assigned at birth, usually based on external genitalia) does not align their gender identity (i.e., one’s psychological sense of their gender). Some people who are transgender will experience “gender dysphoria,” which refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.

People who are transgender may pursue multiple domains of gender affirmation, including social affirmation (e.g., changing one’s name and pronouns), legal affirmation (e.g., changing gender markers on one’s government-issued documents), medical affirmation (e.g., pubertal suppression or gender-affirming hormones), and/or surgical affirmation (e.g., vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.). Of note, not all people who are transgender will desire all domains of gender affirmation, as these are highly personal and individual decisions.

It is important to note that gender identity is different from gender expression. Whereas gender identity refers to one’s psychological sense of their gender, gender expression refers to the way in which one presents to the world in a gendered way. For example, in much of the U.S., wearing a dress is considered a “feminine” gender expression, and wearing a tuxedo is considered a “masculine” gender expression. Such expectations are culturally defined and vary across time and culture. One’s gender expression does not necessarily align with their gender identity. Diverse gender expressions, much like diverse gender identities, are not indications of a mental disorder.

In order to meet criteria for the diagnosis, the condition must also be associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.

GD is only considered a mental disorder when it causes distress and/or impairment. It the distress/impairment that is diagnostically significant. GD is not a psychiatric disorder in itself.

[Lagayascienza]

I did not say that it was no longer listed in the DSM-5. I said it was no longer listed as a psych-sexual “disorder”. The diagnosis was renamed from “gender identity disorder” to ‘gender dysphoria’. The word disorder is no longer used. And for a diagnosis there must be mental distress caused by the dysphoria. The term "disorder' is no longer used diagnostically. Interestingly, the DSM also uses the term “gender identity” which you, but not others, find so problematic. The following is from the DSM website:

The term “transgender” refers to a person whose sex assigned at birth (i.e. the sex assigned at birth, usually based on external genitalia) does not align their gender identity (i.e., one’s psychological sense of their gender). Some people who are transgender will experience “gender dysphoria,” which refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.

People who are transgender may pursue multiple domains of gender affirmation, including social affirmation (e.g., changing one’s name and pronouns), legal affirmation (e.g., changing gender markers on one’s government-issued documents), medical affirmation (e.g., pubertal suppression or gender-affirming hormones), and/or surgical affirmation (e.g., vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.). Of note, not all people who are transgender will desire all domains of gender affirmation, as these are highly personal and individual decisions.

It is important to note that gender identity is different from gender expression. Whereas gender identity refers to one’s psychological sense of their gender, gender expression refers to the way in which one presents to the world in a gendered way. For example, in much of the U.S., wearing a dress is considered a “feminine” gender expression, and wearing a tuxedo is considered a “masculine” gender expression. Such expectations are culturally defined and vary across time and culture. One’s gender expression does not necessarily align with their gender identity. Diverse gender expressions, much like diverse gender identities, are not indications of a mental disorder.

In order to meet criteria for the diagnosis, the condition must also be associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.

GD is only considered a mental disorder when it causes distress and/or impairment. It the distress/impairment that is diagnostically significant. GD is not a psychiatric disorder in itself.

[Lagayascienza]

Sorry for the double post. Gremlins.

[Consul]

I did not say that it was no longer listed in the DSM-5. I said it was no longer listed as a psych-sexual “disorder”. The diagnosis was renamed from “gender identity disorder” to ‘gender dysphoria’. The word disorder is no longer used. And for a diagnosis there must be mental distress caused by the dysphoria. The DSM also uses the term “gender identity”. The following is from the DSM website:
…
GD is only considered a mental disorder when it causes distress and/or impairment. It the distress/impairment that is diagnostically significant. GD is not a psychiatric disorder in itself.

Yes, it is, according to the DSM = Diagnostic and Statistical Manual of Mental Disorders. If gender dysphoria were no longer regarded as a mental disorder, it would no longer be mentioned in the DSM-5. That the term "gender-identity disorder" is now replaced by "gender dysphoria" makes no difference with regard to gender dysphoria's being a mental disorder (according to DSM-5).
Moreover, gender dysphoria "is associated with clinically significant distress or impairment" by definition. That is, nobody is gender-dysphoric unless s/he experiences clinically significant distress or impairment.

"Diagnostic Criteria:

Gender Dysphoria in Children 302.6 (F64.2)
A. …
B. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning.
…
Gender Dysphoria in Adolescents and Adults 302.85 (F64.1)
A. …
B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning."

(Diagnostic and Statistical Manual of Mental Disorders [DSM-5]. 5th ed. Arlington, VA: American Psychiatric Association, 2013. pp. 452-3)

"Gender dysphoria replaces the previously termed gender identity disorder in the DSM-IV-TR. Changing from disorder to dysphoria reduces the notion that an individual has a disorder because he or she identifies with a gender other than the one he or she was born into (APA, 2013b, 2013c). Although there was considerable debate from the lesbian, gay, bisexual, and transgender community about keeping gender dysphoria in the DSM, APA advocated that retaining this as a mental disorder will promote treatment: "To get insurance coverage for the medical treatments, individuals need a diagnosis. The Sexual and Gender Identity Disorders Work Group was concerned that removing [gender dysphoria] as a psychiatric diagnosis—as some had suggested—would jeopardize access to care" (APA, 2013b, p. 2). For example, clients can advocate for hormonal and surgical treatments such as gender reassignment surgery because of the clinically significant distress associated with this condition (APA, 2013b; Megeri & Khoosal, 2007)."

(Dailey, Stephanie F., Carman S. Gill, Shannon L. Karl, et al. DSM-5: Learning Companion for Counselors. Alexandria, VA: American Counseling Association, 2014. p. 126)

[Sy Borg]

Not so long ago, homosexuality was listed in the DSM-5 until 2013.

Implying that transpeople are delusional because they are listed in the DSM-5 is effectively an appeal to authority, and a most fallible authority that only ten years ago would have people believing that gay people were so because they were mentally ill. Yet many of us - untrained as we are - would have already been well aware that gay people were not deluded heterosexuals.

[Lagayascienza]

Something like 3-4% of the population are homosexual. If the old DSM had been correct, it would mean that 3-4% of the population were mentally ill just because they were gay. That's ridiculous. The great mathematician, computer scientist, logician, cryptanalyst, philosopher and theoretical biologist Alan Turing, and so many like him, were not mentally ill but so hounded by their society because of their sexuality that they were driven to suicide.

It's just as ridiculous to call people with gender dysphoria mentally ill. Their suffering is a result of others not wishing to allow them to live as the gender they feel themselves to be and not because they feel themselves to be a certain gender. Their suffering is inflicted by their society.

The DSM has always been a flawed document. However, people with GD understand that keeping GD in DSM-5 means that they can get health insurance to cover the cost of gender reassignment which would be out of reach for most if they had to find the money themselves. So, people with GD are in a bit of a bind. They are either classified as having a mental disorder so that reassignment is affordable, or they are removed from the DSM and cannot afford the treatment they need.