Re-evaluating sex and gender

Medical experts have released a paper calling for a re-evaluation of the conflation of sex and gender. They say they are concerned about the early push for body modification and medical treatments instead of addressing the psychiatric issues.

Psychiatrists Lucy Griffin and Katie Clyde; along with GP Richard Byng who is also a Professor of Primary Care Research at the University of Plymouth; and Professor of Obstetrics and Women's Health Susan Bewley, have worked together on a comprehensive report to expose concerns about the political agenda at play.

They say that the World Health Organization makes decisions that reflect “a political rather than scientific decision-making process.”

There is a lack of consensus demonstrated as to the exact nature of the condition. Questions remain for psychiatrists regarding whether gender dysphoria is a normal variation of gender expression, a social construct, a medical disease or a mental illness. If merely a natural variation, it becomes difficult to identify the purpose of or justification for medical intervention

The paper criticises the blanket term “conversion therapy” stating that “conversion therapy for transgender people appears conflated with that for homosexuality. Furthermore, there is little evidence that it is taking place in the UK.”

They express concern that self-identification is being considered more valid than a medical diagnosis while expecting doctors to treat them with complex medical treatments. They state that gender identity is being too readily disassociated from biological reality.

If one's ‘internal sense of being a man or a woman’ no longer refers to a ‘man’ or ‘woman’ as defined by biological sex then the definition of gender identity risks becoming circular.

Within current debates, if gender identity becomes uncoupled from both biological sex and gendered socialisation, it develops an intangible soul-like quality or ‘essence’. As a pure subjective experience, it may be overwhelming and powerful but is also unverifiable and unfalsifiable.

How should doctors consider the body? We are born as, and die as, a body; we are our bodies. How can someone be born in the wrong body? …  We must deal with all our patients with compassion but also make safe medical decisions when demonstrable material reality is at odds with a patient's subjectivity.

These experts go on to question what role psychiatry can play if gender dysphoria is no longer considered a diagnosable mental illness.

Psychiatrists understand that human development is necessary, but not always comfortable. Puberty, although a normal physiological process, is associated with particularly high levels of psychological and bodily discomfort. Psychiatrists’ role is to journey with patients as change is navigated and to provide support through sharing uncertainty and difficult decision-making. But in the current climate, psychiatrists may be unsure whether addressing psychological and social antecedents will lead to accusations of conversion therapy. Attempts to reconcile a sufferer's discomfort with their actual body would be good practice in other conditions involving body image disturbance, such as anorexia nervosa.

Language that confuses or conflates sex and gender identity, while appearing inclusive, might have the unintended consequence of closing down the means to understand complexity and respond appropriately to patients’ emotional and material reality.

They rightly claim, “when multiple medical interventions are required on an otherwise healthy body or doctors are expected to deny the concept of sex or the sexed body, the situation becomes less coherent.”

Binary spokeswoman, Kirralie Smith, said the paper was clear and comprehensive.

“This is a fantastic resource by medical professionals. They lay bare the political nature of the trans agenda,” she said.

“The paper clearly exposes the shortcomings of the ‘conversion therapy’ arguments and raises important facts about the medical and psychiatric nature of gender dysphoria.

“It is a must read for anyone concerned about the rise of the trans agenda in our society.”