Motus Mentis

Here is an article from Vox about a trans-gendered high-school student, with a female body, who wants to use the boy’s bathroom. The title of the piece is:

A federal judge said being transgender is a mental disorder. Here’s why he’s wrong.

The piece relies for its argument on the recent (2013) reclassification, by the Diagnostic and Statistical Manual of Mental Disorders (DSM), of transgenderism from “gender identity disorder” to “gender dysphoria”:

When the DSM’s medical diagnosis of trans people changed from gender identity disorder to gender dysphoria in 2013, the American Psychiatric Association explained this in explicit terms: “Part of removing stigma is about choosing the right words. Replacing ‘disorder’ with ‘dysphoria’ in the diagnostic label is not only more appropriate and consistent with familiar clinical sexology terminology, it also removes the connotation that the patient is ‘disordered.'”

Under the manual, gender dysphoria is treated as a temporary, treatable condition, not a permanent disorder. If left untreated, it can lead to distress, depression, and suicidal ideation, among other problems.

Most medical experts today, including the American Psychiatric Association and American Medical Association, agree that letting someone transition without social stigma can help treat gender dysphoria. And not all trans people deal with severe dysphoria in the first place. Both of these facts show that psychological distress and disability aren’t inherent to being trans, so being trans doesn’t meet the definition of a mental disorder (a psychological state that causes significant distress and disability).

The idea seems to be that to be a “disorder”, a condition must cause “distress”. Therefore, if we can reorganize the entirety of the external and pre-existing world in such a way as not to impress upon the afflicted person that he or she is in any way out of normal working order, then the distress will vanish, and we can solve any remaining bureaucratic problems simply by redefining the former “disorder” as a mere “dysphoria” (which, despite the downgrade from “disorder”, apparently should not be “left untreated”).

But how is transgenderism not, in fact, a mental disorder? It certainly does cause a good deal of distress, after all; the suicide rate among transgendered persons is nine times the national average. You may argue that this just means we still have “work to do” in getting the whole rest of the world to adjust their attitudes about what is “normal”, but at some point one must face the fact that the existing realities of the world, and of human nature, are not things you can just wish away, no matter how earnestly and righteously you may wish. More importantly: it is disingenuous, to say the least, to insist that all of the distress felt by transgendered people is wholly exogenous, and not due, at least in part, to their intrinsic awareness of a grave inner disharmony.

It is conventional, now, to refer to being transgendered as being born in the “wrong body”. But the issue is really a matter of the relation between mind and body. The normal, correctly ordered, distress-free configuration is for gender identity, biological sex, and the polarity of sexual attraction all to line up congruently, as they do in all but a tiny percentage of the population. To be homosexual or transgendered means that there is disharmony in the relation between some or all of these nodes. The body itself is one corner of the triangle — and is, except in actual hermaphrodites, determinably and unambiguously male or female. Any disharmony, then, is a subjective, inner perception. Why is it wrong to classify this as a mental phenomenon? Why do we insist that in transgenderism, the body is what’s out of order, and the appropriate target of intervention?

You might respond that, because transgendered people are “born that way”, it is not a “mental” issue in the sense of being remediable by conventional psychotherapy. That certainly may be true in many, or even most, cases. But there are plenty of other congenital mental conditions that are classified as disorders — and indeed almost every “mental” trait, from intelligence to the whole spectrum of behavioral dispositions, are highly heritable, and therefore at least partially innate.

None of this is intended to stigmatize or blame those who are, in fact, “born that way”. But we seem to have a bizarre obsession, these days, with the idea that all sorts of handicaps, abnormalities, and disabilities are now to be “celebrated“. At the very least, can we not acknowledge that to have such dissonance in such a fundamental aspect of our inner organization is unfortunate? And that it is, in any important sense, a mental issue? Is it so unreasonable to respond to transgenderism not with celebration, but with sympathy?