Thursday, May 9, 2013

Ch 14: Gender Dysphoria as a physical condition and how it leads to other mental conditions



I hope everyone is doing well today,

   In talking to others and doing some research and looking at my own situation today I looked at the prevalence of personality disorders which are a mental condition among transgender individuals.  Because generally the gender dysphoria itself isn't considered a mental issue, and is a fixable physical issue, or is at least starting to be viewed that way.  But in either case, the issues that surround being transgender generally cause stress, anxiety, depression and other issues which are viewed as mental issues.

    "Sex is assigned at birth, refers to one’s biological status as either male or female, and is associated primarily with physical attributes such as chromosomes, hormone prevalence, and external and internal anatomy.  Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for boys and men or girls and women. These influence the ways that people act, interact, and feel about themselves. While aspects of biological sex are similar across different cultures, aspects of gender may differ. Various conditions that lead to atypical development of physical sex  characteristics are collectively referred to as intersex conditions," (http://www.apa.org/topics/sexuality/transgender.pdf).

   The statistics said that at least for transgender individuals who also have a chemical dependency they have almost double the likelihood of having some other type of personality disorder.  The most common disorders being Obsessive Compulsive Disorder, Borderline Personality Disorder, and other Anxiety or control issues.  These disorders are developed as the transgender individual grows up having to hide from society and learns behaviors to overcompensate for their lack of masculine or feminine traits.

   OCD can develop from children who try to overcompensate and obsess over worrying someone is going to find out their 'secret' which to them is something that they aren't supposed to express because generally speaking we as a society link birth sex to gender quite often.  Borderline Personality can come from not focusing on oneself for a long period of time, and then in realization of the transgender state or 'condition' they become very self absorbed and have a hard time considering other peoples needs.  And control issues can come up from similar states to OCD but in relation to having to control all aspects of life in order to ensure a safe environment out of fear of discrimination, hate or that in general things may just fall apart.

   "A psychological state is considered a mental disorder only if it causes significant distress or disability. Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures, and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression, or related disorders at higher rates than nontransgender persons.  
   In the United States, payment for health care treatment by insurance companies, Medicare, and Medicaid must be for a specific “disorder,” defined as a condition within the International Classification of Diseases (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). According to DSM-IV , people who experience intense, persistent gender incongruence can be given the diagnosis of gender identity disorder. This diagnosis is highly controversial among some mental health professionals and transgender communities.  Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care," (http://www.apa.org/topics/sexuality/transgender.pdf).
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   So, I came upon this topic in discussing my own personality as a 'fixer' or someone who sees a problem and wants to take care of it.  Many 'men' do this as they are taught that they are the caretaker, the one to provide for the family and look out for their protection.  This can be viewed as a type of OCD, and I will be honest when I first got together with my wife I was very controlling and didn't really want to have someone else coming into my life and messing with the order of my 'chi' so to speak.

   In discussing the issue, I looked at it from a social standpoint and thought that it is likely that many transgender individuals from their own experiences can sometimes be very generous souls.  In saying this I'm talking about the need and want to take care of others in their own way, however this puts us in a dangerous situation where we can easily be taken advantage of.  Of course for some reason we tend to almost attract those people who are the 'takers' as we are willing and get validation of our self-worth by giving what we can freely.  However, as you can see if your always giving and never taking the balance of any relationship can become very lopsided and while your helping the other person it can sometimes be at the detriment of your own health.

   The other hard truth I had to learn, is that while it's painful to see loved ones fail, you CANNOT save everyone and trying to not only usually doesn't help the other person with what they actually need but enables them and hurts you in the process.  Allowing them to fail and learn their own lessons they become self-sufficient and largely can learn and cope much better in the world by being able to earn a level of independence.   It is really hard to let go of that control, and let someone do something you know isn't going to work especially when you get validation in terms of self-worth through low self-esteem by helping others, but in the long run it is healthier not only for you as the giver, but them as the taker as well.

to be continued...
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