Replacing outdated diagnostic categories
So having gotten that off my chest I’ll regale you with what the Experts say. Courtesy of the World Health Organization I give you Gender incongruence and transgender health in the ICD. What’s the ICD? International Classification something. Directorate? Department? Dogma? I don’t know. I’ll let you know if I find out.
ICD-11 and Gender Incongruence
The 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11). The newly revised ICD-11 codes includes new changes to reflect modern understanding of sexual health and gender identity.
Hmm. Modern understanding or modern batshit crazy?
ICD-11 has redefined gender identity-related health, replacing outdated diagnostic categories like ICD-10’s “transsexualism” and “gender identity disorder of children” with “gender incongruence of adolescence and adulthood” and “gender incongruence of childhood” respectively. Gender incongruence has been moved out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to sexual health” chapter. This reflects current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma.
Ahhhh ok, I see where we are now. We’re pretending that reality-defying notions about
“gender” are not reality-defying notions at all but important new insights into how absolutely true it is that if Jim says he’s a woman he absolutely is a woman no matter what’s in his pants, and furthermore it’s very healthy and life-affirming that he is in touch with his inner wooooomannn.
What is Gender Incongruence?
Gender incongruence of adolescence or adulthood : Gender Incongruence of Adolescence and Adulthood is characterised by a marked and persistent incongruence between an individual´s experienced gender and the assigned sex, which often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender, through hormonal treatment, surgery or other health care services to make the individual´s body align, as much as desired and to the extent possible, with the experienced gender.
Hm. One, that is circular. Two, it doesn’t answer the question, it just restates it. Other than that it’s brilliant stuff.
It’s a tad alarming that this masticated gorp is coming from the World Health Organization, don’t you think?
It’s all about how comfortable one feels when they don’t fit in. Take tomboys, for example. Some tomboy girls don’t mind being different, being outliers. Other tomboy girls internalize it and it manifests as guilt, shame, anxiety, distress. Which way anyone goes is partly influenced by her personality, temperament, disposition, her natural character. But it’s very largely influenced by her cultural milieu. Social environments that are hostile to tomboy girls will create more distress among tomboy girls. Social environments that tolerate them will give more confidence to the outliers, and it will frankly create more outliers, too — more tomboys. Because there’s less pressure to get in line with “gender” norms.
So the question becomes, what’s with the sudden surge in people experiencing “incongruence” about their “gender” — a dislike about where their gender-ish attributes (e.g. tomboyishness) situate them in the social landscape? Especially since society had until recently been an increasingly comfortable place for tomboys? That seems like a very alarming sign that society is backsliding on gender diversity.
It used to be that social “gender norms” were so strict, only the most determined girls could even openly be tomboys. Then, as social strictures loosened, more girls came out as tomboys.
Now, it’s for some reason seen as a natural extension of progress to take those tomboys and medically treat them. This seems like a complete reversal.
I think it’s a symptom of an excess of individualism.
The societal shift to let tomboys be tomboys represented a step forward in freedom of individual expression. But just because girls were now free to be tomboys, they were not completely rid of the social stigma that came with it. That stigma had been diminishing over time, but at the same time, the movement to further advance freedom of individual expression was racing ahead. It’s now gotten to the point that free expression means freedom not just to express your tomboyishness, but also freedom to remove yourself from any feeling of stigma or not fitting in that might accompany it, as it’s still seen as somewhat outlier behaviour for girls.
So the trans movement feels like a blip in time where the forward march of freedom of expression has briefly overtaken the march to push back social stigma around being a gender outlier.
There’s way less stigma around tomboys now than there was, but there’s way more encouragement to react to any kind of stigma in your own personal-freedom-y way — internalize the stigma as gender-dysphoria to your heart’s content if that’s what you want!
It went from “it’s fine that you’re a tomboy. life might be a little harder, but that will give you grit, and over time, it won’t be so hard, as society catches up with you and your brave gender bending” to “it’s fine that you’re a tomboy. But if you feel like not fitting in is making you feel bad, we can liberate you from that feeling thorugh ‘gender medicine’, making you even free-er!”
And of course, the internet is just encouraging all the tomboy girls, and all the feminine boys, and all the autistic misfits, and all the gays, to seize the chance to “fix” themselves to get out of the fear of stigma, instead of learning some grit, leading by example, and us all working collectively to reduce stigma around gender atypical behaviour and presentation.
Frankly, it’s so obviously a bad move. And it’s not doing anything to eliminate the stigma, it’s just encouraging more of it.
Does any of this work if the “gender incongruence” occurs outside of The United States of America?
So, my sex is assigned, but my gender is experienced. If I have incongruence, I have to bring my sex, which is assigned, into alignment with my experienced gender, which is not assigned and is therefore not my sex, through alterations of my BODY, which is not assigned but born-with. So that means the body can’t be the sex, can it, since sex is assigned, not born-with? So why alter it, then? I mean the body. Why fuck with the born-with body to satisfy congruence between the assigned and the experienced when apparently THE BODY IS NEITHER ONE??
I seem to be experiencing some confusion here.
I’m looking forward to their reclassification of anorexia as “weight incongruence of adolescence and adulthood,” moving it out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to alternative concepts of fitness and health” chapter. Those with anorexia will be allowed to accuse those who don’t share or believe their body-self image as being hateful, fat-shaming bigots. It will be considered cutting-edge, compassionate, weight-affirming treatment to allow those with weight incongruence to starve themselves to death in order to meet their completely normal, healthy body image goals.
But what happens when the boundless enthusiasm for “as much as desired” runs into immoveable brick wall of “to the extent possible”? The “extent possible” is close to zero. The functional biology of the opposite sex is unattainable to anyone not “assigned” it at birth, as that assignment was made at conception, and goes from the molecular level on up. Surgical butchery can’t change that, it can only provide a crude visual approximation at great cost to the actual bodily health and integrity of the physical, material body subjected to it, all in the name of propitiating an undefined “identity” which likely does not exist. All of this terminological juggling and euphemization is in service of protecting and promoting the concept of “gender identity” rather than the actual health of those with supposed “gender incongruence.”
Just like the newly proposed “studies” to determine the efficacy of the improper use of puberty blockers, the goal is to shore up the “diagnosis” and “treatment” they’ve been happily using in spite of manifest, dangerous contra-indications. They’re looking for ex post facto justification and absolution for the harm they’ve already caused. Cart before the horse. Where was this newly found concern and curiousity before they started drugging children? Given their poor standards and lack of judgement, how can theyse “clinicians” be trusted to accept any findings that go against their faith? How can they assure anyone that there won’t be massive cherry-picking and bias confirmation (which is what they’re already going on)? Why does anyone think this is a good idea? Why are children being used as crash test dummies in experiments that are the equivalent of seeing what happens to unsecured passengers in automobile accidents? Answer? Nothing good. We know that already. No need to revisit the bad old days of no seatbelts in cars. How about removing smoke alarms from homes next? These “doctors” are not trying to save children, they’re trying to save their ideology.
Arty, the internet is going further than that. I am aware of gender-conforming people who suffer from depression, anxiety, or something similar. Because it’s what you do these days, they google their symptoms. That immediately leads them to ‘gender dysphoria’ and ‘you might be (probably are) trans’. No matter if they never showed any gender dysphoria, never were tomboys or girly-boys, never felt ‘wrong’ in their body before. All of a sudden, they are wrong in their body, they knew it their whole life, they showed all these symptoms, and people treated them badly for it, etc etc etc. None of which happened.
It’s sort of like the Christians. They have these canned stories, even have books to provide them for you, about your ‘history’ and your ‘coming to Christ’ story, and you can pick the one you like and use it to convince those who doubt by ‘your story’. Even if none of it ever happened. And they become convinced, thoroughly convinced, that every bit of it is true. They remember it that way. They build elaborate scenarios around falsehoods that feel true to them.
Meanwhile, the depressed, anxious, OCD, bipolar, etc, are not getting the treatment they need. They are being welcomed into the trans ‘family’ with open arms, which makes them feel temporarily good, like they belong, like finally they fit in, and it becomes hard to see their way back out to the world where they didn’t fit in…even if it had nothing to do with being gender non-conforming. There are a lot of ways not to fit in; trans has managed to coopt them all.
Omigod so true!
Apparently there’s an entire cottage industry of atheist-to-Christian “conversion” stories. I hear that the evangelical world is rife with them. From what I gather, practically every Born-Again Christian was once a card-carrying CFI member who personally performed eleventy abortions before he eventually found Jeebus.
It’s kinda hilarious to me, because it’s so obviously not true. I think I’ve met exactly one such person in my entire life. Nobody goes from atheist to Christian. The traffic is very much jammed in the other direction. The one lone car I ever saw driving the opposite way of the near-gridlock exodus from Christianity: his newfound faith came — no surprise — after a mental health meltdown and personal crisis following a tragedy. Couldn’t be further from a rational, thought-through decision made in the light of reason and emotional stability. Literally, the opposite of that.
Come to think of it, we treat trans “discovery” stories in the same way. They’re always tinged with tragedy. “Trans people” ALWAYS discover their transness right at the nadir of a personal crisis. (See: Ellen Page, who was in the midst of a schizoid psychotic break when she “discovered” she’s a dude. Or Bruce Jenner, who came out as “Caitlyn” right after the District Attorney’s office announced it was going to arrest him and charge him with vehicular manslaughter. Does nobody but me remember that Bruce Jenner killed a woman via reckless driving on the PCH in Malibu?)
Nobody discovers they’re trans while buried in research books in a library. Scientific “eureka!” strokes of enlightenment these very much fucking aren’t!
It’s all so very, very spiritual. I wonder if that insight will ever penetrate the old Atheist-plus crowd. And if it does, I wonder what they will do about it.
But I know my history, and I’ve read enough about human behaviour to know quite well: people will not willingly come to terms with a mistake this big unless they’re absolutely forced to, in handcuffs, sometimes even at gunpoint.
If you’ve ever seen a Law and Order episode, you know that the guilty party never confesses until he’s forced to answer questions under oath, and even then he’s gotta be utterly, absolutely cornered by evidence and the law before the penny drops.
After the Holocaust, Allied soldiers forced German civilians at gunpoint to tour the death camps — to see them with their own eyes. Some of the Germans became nearly unhinged, so desperate they were to not see (almost an inadvertent pun there, sorry ’bout that) what they’d been quietly complicit in. They vomited; they fainted. Not from the horrors of what they saw, necessarily, but from the internal terror of their worldview being ripped apart. They’d lived in cognitive-dissonant bliss for so long, that to finally face the reality of what they’d been complicit in utterly destroyed their own sense of self-righteousness.
I see a reflection of that in my dearest, oldest friends who ghosted me without saying a word. They just couldn’t face what was going on.
There’s an excellent film called The Zone of Interest, about Rudolf Hoss, the commandant of Auschwitz, who lived a happy suburban life with his wife and kids in a pretty little house right outside the death camp amid the sounds of gunfire and the smell of burning flesh. The film has been called an “examination of human complicity.”
In one scene, Hoss’s wife hosts a social lunch with her friends, a delightful little afternoon tea affair. All the while, you can hear the goings-on at Auschwitz right outside the house.
I think of that particular scene when I imagine my circle of erstwhile friends — it was once my substitute family, at least sometimes — who I used to have Christmas dinner with every year for well over a decade. I think about them getting together for Christmas without me, without saying a word about my absence or what’s going on.
The phenomenon of human complicity does indeed need more examining. Much more.
https://www.youtube.com/watch?v=r-vfg3KkV54
My apologies if this comment is somewhat disjointed; I know what I want to say but I’m still working on the best way of saying it.
That can’t be right because gender isn’t something that can be ‘experienced’ in any meaningful way. ‘Gender incongruity’ is really the result of not only accepting the old gender stereotypes – boys and men act and think in ways a,b,c; girls and women in ways x,y,z – as being the essential markers of manhood/womanhood, but doing so in a new way in which manhood/womanhood is not linked to one’s biological makeup but is entirely predicated on one’s inner feelings of ‘gender’.
We know that the stereotypes are wrong and that there is no ‘way’ to be or feel like a man or like a woman, but the ideology that has grown up around gender non-conformity encourages people to believe the opposite, that the gender stereotypes are real, and that has led to a massive error in how people think about themselves. Obviously, a man does not – indeed cannot know what it feels like to be a woman: I, for example, can only know what it feels like to be me, but the ideology says otherwise. Where the ‘experts’ should be saying ‘if you don’t feel that you meet the stereotypical requirements to be a man, that’s fine, the stereotypes are wrong and you are still a man regardless’ what they are saying is ‘if you don’t feel that you fit the male stereotype then by definition you must instead fit the female stereotype and therefore you are really a woman’. So now, in a macabre new twist, instead of people being encouraged to adapt their ideas about the stereotypes and learning to accept themselves for who they are, they are being manipulated into believing that not feeling like ‘a’ means they must be ‘b’, and if they are ‘b’ then it follows that it is essential that they make changes to their bodies to better resemble ‘b’.
ICD-10-CM Diagnosis Code W56.22XA
Struck by orca, initial encounter.
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No reason, just my favorite ICD code…
Exactly. I can’t extend my own experience to other men, let alone women. Me is all I’ve got. I have no other frame of reference. I happen to be male, but I can’t claim any expertise in “maleness” or “being a man.” I assume some degree of similarity and commonality with other humans, in that they will have their own subjectivities, but I can’t know what those subjectivities are. I am bound by and to my own experience. I can’t claim that mine is better, or different, or wrong, as I can’t “try on” anyone else’s in anything but a limited, imaginative way, through, say, reading the thoughts and perspectives of others. But this is more like getting a postcard, not even being a tourist. It’s a message from outside, not a personal visit. And you certainly can’t live there. You can get a feel for it, but you can’t know it.
To claim that one is something they’re not (and can’t be) is, quite apart from impossible, presumptuous and wrong-headed. “Gender identity” presupposes some essential “maleness” or “femaleness” of perception, perspective, or personality that is independent of both the sexed body, and the individual, offering some interior standard of comparison to judge against from within the self. How else can they say “I’m not A, but B”. How can you know this if you have never been a B and can never be one? You can’t step out of A, or into B. How would you know? It would be like me wondering if how I see a given shade of blue is the same as everyone/anyone else’s perception, and confidently claiming my own perception is wrong.
Amputees who have “phantom” limbs have experience of once having had the now missing limb. Someone who is now old has had experience of once having been younger. They have relevant experiences that allow them to compare and judge these two states of being and perception. (Whether their memories of these states of being is accurate might be another question, given the cliche of polishing, embellishing, and remaking our own histories, wherein “When I was young, we had to walk twenty miles to school every day, uphill in both directions!” is another question.) These are comparisons we can have license to make because they’re part of our personal histories. They’re in our CV. Being the sex one is not isn’t. There is no relevant experience that can allow you to claim another state of being. This is not to say that those few with actual dysphoria are not experiencing discomfort and suffering, but the cause is not being “in the wrong body.” The cause must be something other than a supposed “incongruence” between Soul and Body. Descartes is dead: long live Zombie, Gender Identity Descartes.
You are the body you’re “in”. You can’t visit other bodies to see if their grass is greener. You can see how the other half lives, but you can’t be the other half. Not for an instant. You’re stuck with your own grass, weeds and all. “Treating” your lawn with napalm is not going to make it any greener. Quite the opposite in fact. Attacking the body seems to be a poor choice for dealing with something that seems to be, on the face of it, purely psychological. This is “mind over matter” taken to a destructive extreme. Wasting time, energy and lives on “treatments” that can never work, can only postpone or prevent solutions that can actually alleviate the mental suffering that sterilization and mutilation never will.
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ICD-10-CM Diagnosis Code W55.81XA