What should we want from doctors?
In creating DSM V, experts distinguished unusual behaviour from distress arising from that behaviour. A paraphilia is only a disorder if it causes suffering for the patient. The distress arises from the disjunction of what the person desires, and what s/he thinks s/he should desire. Unfortunately, the distinction has not always been observed: it was thought the distress arose from the desire, so the treatment was to change the desire. That was the basis of my own aversion therapy in 1992: the psychologist offered me a choice, and could have sought to make me more comfortable with the desire, but instead sought to increase my disgust, and change my desire to other channels. Better to seek to change desire than squash it. But desiring women is compatible with cross-dressing.
The issue as I see it now is not fitting how “Men” are supposed to be. Cross-dressing, cross-dreaming or identification is a way of coping with that, symptom not cause. Sexual arousal is incidental.
The Danish Girl makes the doctors monsters. One points radioactive sources at Lili’s genitals because science, and because he has this expensive equipment which must be used for something. One calls her schizophrenic and wants to lock her up. One performs the first SRS under medical conditions, but then implants a womb so that she dies from organ rejection. The Franken-doctor’s reputation would have been so great had the operation succeeded!
Doctors want to fiddle around and do something rather than leave well alone. Or- doctors seek to make the person better able to cope with life, but don’t always see the best way to do that. Surgery is better than trying to make the trans woman more Manly.
Self-acceptance is the cure. We come to enjoy our coping strategies rather than being ashamed. They become less compulsive, less isolating. I don’t know whether this is in the air or I am just more aware of it. T-Central’s latest share is a review of a book along those lines. I would highly recommend retiring from gender to anyone who is feeling like the spectrum or the binary doesn’t fit. Many people look at me strangely when I tell them, but the decreased pressure of having to perform a gender makes up for all the misunderstandings.
Would anyone want surgery if it were not the path to being acceptable to the general public? I don’t know. Seeking to pass as a woman is seeking to fit in with gendered society. That means hormones and hair removal is a surrender, compromising being me in order to fit in. Of course, everyone compromises to fit in, from speaking differently at work and in the pub, to following fashions rather than creating them.