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Transgender and Psychology

This past weekend was the annual APA convention. The big news of the convention was the recent discovery that APA was involved in torture. Not surprisingly, this involvement seems to be money-motivated, and also not surprisingly, the vast majority of voting Psychologists agreed that torture was a bad thing.

Of lesser "news", but, in my opinion, greater importance was a brief, one-hour discourse on how Psychologists are/should clinically treat transgender children. The development of empirically (research) supported interventions is moving forward, but I was dismayed at the relatively slow pace reported. I am still, professionally speaking, relatively new to the field, so while some of this is the same old song for you, I am still being dismayed about it. A summary of part of the talk mentioned above is that, while there are a number of treatment strategies outlined, there is no agreement on which is best. Also, there is no agreement on how to categorize individuals with transgender issues (categorizing is essential to providing proper support and treatment in my field, and across fields), no agreement on the source of such issues (although "society" seems to be a unifying source of depression and anxiety for transgender individuals), and no agreed upon outcomes (i.e., How do Psychologists know when they have actually helped a transgender individual?).

I am reading the book Sapiens: A Brief History of Humankind, by Yuval Noah Harari. I recommend the book on its own merits as it is spectacularly written and expansive. Harari suggests that humans are the only creatures that can believe in myth or fiction, and that we use these beliefs to help build cultures. It makes me wonder how much of the difficulty Psychologists are having with being useful to transgender people is based on inadvertant belief in myths. For instance, there is a myth that the physician aiding in the birth of a baby is the best person to determine the gender of the child. I think this myth is propogated by the notion that the physician is often first on the scene, and their guess is usually correct. But the notion that the physician is always correct, or somehow is an authority to determine the gender at the moment of birth is fiction. In reality, the physician is no more of an authority in that moment to assign gender than is the individual who screwed in the lightbuld above the birthing table.

The author goes on to suggest a way to differentiate fiction from reality, or myth from biology, if you prefer. He states, "Biology enables, culture forbids." Psychology needs to be careful about whatever the "do, do not do" advice it is advocating. I am glad we have moved, as a profession, beyond the, "Is transgender a real thing, and not just a mental disorder?" argument. That was getting us nowhere, it seems. Now, what do we promote and what do we forbid? Interestingly, the recent vote at the APA was clearly about forbidding Psychologists to participate in torture. We need to be conscious of the myths we propogate. As scientists, we have no excuse for ignorance.

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