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Mad_Chemist_ t1_iv9mysw wrote

>TGD [transgender and gender diverse] patients had on average more diagnoses than cisgender patients (3.54 ± 1.88 vs 3.04 ± 1.72, t = 2.37, P = .02). After controlling for age, TGD patients were significantly more likely to be diagnosed with posttraumatic stress disorder and borderline personality disorder than cisgender patients (P < .05).

I wonder in which direction the causation goes. Does having mental disorders cause or make one more prone to gender dysphoria? Or does having gender dysphoria cause or make one more prone to mental disorders?

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sudormrf7 t1_iv9sv2a wrote

There are probably three phenomenons at once, all usually championed by different people with different political agendas:

  1. Health professionals that try to protect the patient from regret and/or mistreatment, thereby over diagnosing any mental problems that is remotely possible. Most persons have some weaknesses in their personality, but at a sub-clinical level.
  2. Gender dysphoria tends to make your life hard. Said weaknesses might then develop further or suddenly become a problem.
  3. Gender dysphoria is a deviation from the neurological norm. In some cases there might be an underlying factor that caused both a deviating gender identity and some other neurological condition.

But I strongly find it not probable that a mental disorder causes gender dysphoria. In the same way that it doesn't cause homosexuality. Most of us have a gender identity disposition that we're born with that blooms in our early childhood. That is completely normal as long at it agrees with your physical sex. In a well developed humane society, a deviating gender identity should be constructively taken care of. (e.g. gender transition and acceptance from the rest of society.)

The science is not complete on the etiology, but we know there is a genetic link to the genes linked to the degree of feminization and masculinization (e.g. https://academic.oup.com/jcem/article/104/2/390/5104458?login=false). If you do a quick google scholar search, you will see that there is a lot of really good arguments for that it's biologically linked. Genetic, hormonal and environmental during the fetal stage of development (when your mother was pregnant.) In other words, with today's science our best conjecture is that gender dysphoria is caused by a brain born with a gender identity disposition deviating from birth sex.

Personally, I wouldn't be surprised if the truth includes a little bit of all of these three explanations. We will probably find that there are several complex biological paths to gender dysphoria, e.g. combinations of hormones during the fetal stage, genetics, teratogens (toxic chemicals) etc.

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KarmicComic12334 t1_ivckc6w wrote

A fourth possibility, that gender nonconforming people are more likely to be sent to speak with a mental health professional and that people who do not go to visit mental health professionals are rarely diagnosed. People can and do go through their whole lives with BPD and PTSD without anyone around them noticing or caring, but gender dysphoria presents as difficult to ignore.

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sudormrf7 t1_ive7s41 wrote

Yes, that is true! Secondly, it's hard to control for statistically since patients with gender dysphoria are usually investigated much deeper.

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ill_effexor t1_ivbpmr8 wrote

>1. Health professionals that try to protect the patient from regret and/or mistreatment, thereby over diagnosing any mental problems that is remotely possible. Most persons have some weaknesses in their personality, but at a sub-clinical level.

  1. Gender dysphoria tends to make your life hard. Said weaknesses might then develop further or suddenly become a problem.

Isn't this here problematic. Instead of protecting people from their problems and issues shouldn't we be teaching them copeing methods.

I understand not everyone can be treated this way alone but shouldn't we avoid diagnosis as a crutch?

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sudormrf7 t1_ivbuma6 wrote

Yes, I consider such frivolous diagnosing to be damaging. I've witnessed it myself (no further comment).

Still, identifying and helping the individual challenges of the patient is a necessity considering the amount of discrimination in today's society. You need to be a very well balanced and strong individual to thrive in that situation, if not barely survive. At least in my country, this is how it's supposed to happen.

Hopefully, when society matures less intervention will be necessary.

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Ok_Letter_9284 t1_iv9xtr8 wrote

I appreciate the nuanced presentation but I take issue with your conclusion. Gender dysphoria only exists because of the existence of gender ROLES.

A man wearing a dress has nothing to do with mental heath, but is instead a recognition that socially constructed gender roles are dumb.

This is VERY different than the claim that you are in the wrong gender. Not matching socially constructed gender roles would yield a wide variety of behqviors, NOT exclusively the OPPOSITE genders’ behaviors.

Do you see my point? A rejection of gender roles is logical. But that would almost NEVER lead to embracing a different gender role!

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nfgrawker t1_iva46eb wrote

If the trans movement had anything to do with gender roles then surgery and hormones wouldn't be the recommended treatment. They are purely physical.

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Dr_seven t1_ivb0l3x wrote

I think it's a bit more nuanced than that- for example, the studies showing benefits for kids who socially transition only, with no medication, etc. If it was purely a "physical" situation, that wouldn't make a difference.

Speaking for myself, my personal case is certainly more physical than mental- I generally couldn't give a toss what people label me as in public, and don't generally need or request much in the way of validation. However, I'm in the minority, for a lot of folks it makes a real positive impact. I have ASD, though, so this pattern runs throughout most of my life in general, making it hard to compare my experience to the hypothetical average. I'm very rarely subject to any emotional impact from anything people outside my close circles do or say- neurotypical people in general are the opposite, often quite exquisitely attuned to others.

If I had to speculate, it would be that it's both a physical issue (tied to certain physical signs of various hormone shifts in utero) as well as a complex of mental symptoms that depends on environment, family upbringing, and broader culture. I've met some people who are more like me- it's about the physical symptoms and access to medication makes the pain recede. But, there are plenty of people for whom social validation is clearly a major component. This may simply correlate with measures of self-security or other vagaries of personality.

Edit: there's also the somewhat interesting situations wherein men receiving certain treatments for their prostate cancer develop gender dysphoria even though they are being treated as men still. Between social forces and physical factors, it seems that the physical factors win out, but that doesn't make them unimportant, just secondary.

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sudormrf7 t1_iva38t6 wrote

Human emotion is seldom logical, even if one can find an evolutionary reason for their existence. They are only rules of thumb than on an average have increased fitness in a world much different from our own. What is well known is that most of us are born with a gender identity that long-term is emotionally very costly for us to go against. (See the result of tragic surgical experiments on intersex children.)

Our brain is optimized to find patterns. In a society were only women wear skirts, an individual with a completely masculine identity will not want to wear one. Of course a skirt has nothing innate feminine about it, but in that culture it does.

In a hypothetical society were the only difference between men and women was our bodies, gender dysphoria would still exist. But it would probably be more focused on physical differences.

My pet theory is that gender identity is primed by primitive signals, e.g. pheromones (e.g. https://academic.oup.com/cercor/article/18/8/1900/285954?login=false for corroborating experimental findings). During our childhood our neocortex couples that to the patterns in the world we find. That pattern can change depending on society and circumstances.

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uninstallIE t1_ivcv1pv wrote

>Gender dysphoria only exists because of the existence of gender ROLES.

This is not a commonly supported belief. Transgender people often feel dysphoria about the specific physical anatomical structures of their body

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Ok_Letter_9284 t1_iveebzn wrote

So you admit its a mental health issue

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uninstallIE t1_ivexyfy wrote

According to the WHO it is a physical sexual health condition. But even if it were mental health instead, that doesn't change the treatment plan

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Ok_Letter_9284 t1_ivfe6gv wrote

Doesnt change the treatment plan?! You can’t be serious. We don’t change reality to better suit schizophrenia. Or ask that society play along.

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uninstallIE t1_ivfeq9j wrote

So, to be clear, your treatment plan for transgender individuals is

  1. Throw out all the effective treatments that currently work and save their lives

  2. Abuse them harder and prevent them from living their lives until they kill themselves

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Ok_Letter_9284 t1_ivffsxp wrote

Really? Strawman argument much?

Look. If ppl are being fired from their jobs or assaulted, we should deal with that criminally. I’m all for that. I don’t support bullying, violence, or oppression.

But that’s just not what Ive seen from the trans community. The loudest Ive heard them is over Dave Chappell and Lia Thompson.

Contrast that to the BLM movement where ppl are literally being beaten and murdered.

Gays actually DID go through that stuff. But trans using the same playbook as the gays is inappropriate because the issues arent nearly the same.

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uninstallIE t1_ivft6bq wrote

Square this statement

>You can’t be serious. We don’t change reality to better suit schizophrenia. Or ask that society play along.

With supporting the current standards of care for trans people in medicine.

To be clear, to all your delusional ramblings or whatever, trans people do face all those forms of discrimination including police harassment and abuse, beatings and murders, etc etc. So we don't need to talk about the fact that you only care about it when a famous person is criticized for demonizing them

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Ok_Letter_9284 t1_ivjadv2 wrote

To be clear, your counter argument is “nuh uh”. K

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uninstallIE t1_ivjdttd wrote

We aren't changing the topic here from the medical advice, of which my source is the world health organization and yours is the Bible.

I'm not arguing with you about your unsourced opinions on the rates of discrimination when you could just google it and find to you're wrong

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Ok_Letter_9284 t1_ivje0nc wrote

Drilling holes in heads was once the pinnacle of medicine. All the literature agreed.

As someone who’s spent years in the field, we ain’t that good at it yet.

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uninstallIE t1_ivjfce6 wrote

Drilling holes in heads is still a medical practice for certain conditions, and is still the best treatment for those conditions.

So once again are you going to say what treatment you think trans people should receive or are you going to dance around it like an asshole

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DexDevos t1_ivcdvei wrote

Gender dysphoria is something you are born with, it isnt a 'state of mind', it isnt 'a phase' just as much as being gay isnt a 'state of mind' or 'a phase'. Being trans is not a choice.

The question you should be asking is whether being trans means a significantly higher chance of more innate mental disorders, or whether being trans causes undue stress on mind and body due to how society treats us these days, coming out could mean the end of any relationship with your parents or anyone else for that matter after all.

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theronimous t1_iw9ogrg wrote

Why aren’t we encouraging people to accept the body they were born with instead of indulging existing gender based stereotypes? You don’t have to be “masculine” to be a male and being “feminine“ is not a requirement to be female. Physical gender is determined by genetics, not by social expectations of behaviour. Let me ask you this. If a genetic male identifying as a woman goes to a doctor complaining of lower abdominal pain, should the doctor be considered transphobic for suspecting prostate cancer vs uterine cancer?

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DexDevos t1_iwbpuw3 wrote

>encouraging people to accept the body they were born with

Are you advocating for forcing people to conform themselves to the conservative norm and have them repress themselves to depression and eventual suicide?

Accepting your gender dysphoria is impossible, it can only be repressed. You cant understand this fact because you havent lived it. But plenty of people are living this reality and your rethoric, that equates gender dysphoria to petty dissatisfaction with one's body, harms them in so many ways. It's quite literally like dismissing severe depression for 'wanting attention' and to just 'man up'. Telling them to accept their bodies as they are and to just 'don't be a sissy' and to just 'stop being sad' when solutions are so readily available is just evil and cruel.

Just allow people to change their bodies to reflect themselves, whats so hard about that?

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Also, how a doctor treats their patients is irrelevant to the argument, a doctor treats the ailments in accordance to the patients needs, in that setting everything else is irrelevant.

And your argument over genetics isnt that set in stone as you believe it to be either, there are many complicated intricacies there that can result in someone being born a cis-male with xxy chromosomes or a cis-female being born with xy chromosomes.

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theronimous t1_iwd8uue wrote

How do you change genetics? Your body develops based on whats coded in your genome. The fact is that you consider gender based on your own misconceptions and social constructs that define gender as stereotypes. Gender dysphoria is a made-up term based on a false premise. (Define male/female for me, if you can. What is the appropriate “role” for male/female.)

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DexDevos t1_iwvz3b7 wrote

As you are not a doctor or otherwise employed in the psychological research field, you are unable to comment or critique on any medical research with any credence whatsoever unless you educate yourself and give medically relevant arguments for your statements and beliefs. (Sources are also relevant.)

Gender dysphoria is real, not made-up, and has been proven to exist by many medical research papers on the topic. You denying its existence is not "an opinion" or "your freedom of speech", it is factually incorrect and therefore misinformation.

Ironically enough, genetics is what causes gender dysphoria. Biology is a lot more complicated than the highschool level you are familiar with. The current medical hypothesis on what causes gender dysphoria is that it is an imbalance in fetal development in the womb during pregnancy. The brain devlops later than the primary sex organs and if there is a genetic fault that makes the 'fetal hormones' fluctuate between male and female then it is possible for the brain to develop like a typical female brain while the sex organs are that of a typical male, and vice-versa.

The statistical result is a spectrum of male and female with some people falling somewhere in the middle. Life isnt as binary as you would like to believe. Not everything is black and white, it has gray areas like everything else in life.

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theronimous t1_ixt1yps wrote

Psychology is not a medical field, psychologists are not medical doctors. Since you don’t have even this basic knowledge, my respect for anything you have to say on this subject is minimal. I asked a simple question, define gender, which you either refuse to do or are incapable of answering.

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theronimous t1_ixt8t4f wrote

So if someone came to your office convinced they were a bird, your suggestion would be to graft wings to their arms?

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Professional_Band178 t1_ivck1pp wrote

Trans people often have PTSD and BPD because of the trauma that we are subject to both at home and in public because we are not cis. I'm trans female and I have complex trauma because of decades of violent physical and sexual abuse. PTSD is endemic in the wider LGBTQ community because of the abuse and harassment that we are subject to.

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uninstallIE t1_ivcur5v wrote

Transgender people are required to seek therapy in order to obtain their medications and surgeries. I think that's the biggest variable

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SerialStateLineXer t1_ivefhyi wrote

The entire sample consisted of psychiatric patients, so everybody, trans or not, was seeking treatment.

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The_Time_Warp_ t1_ivcibi4 wrote

OP posted this same thing 2 days ago, and has a post history of being repeatedly transphobic. This study has a sample size of 69 people.

I wounder if this could be being posted for some kind of political agenda rather than an actual care for the science. Hmm...

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thetitleofmybook t1_iveiqq1 wrote

this is exactly what it is. a transphobic poster posting things for a political agenda.

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RachelRegina t1_ivc9ctm wrote

Sample size of only 69 patients

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uninstallIE t1_ivcunvm wrote

Every study on transgender people is going to have a small sample size. This is something that is going to have to be expected. It is very hard to find thousands of transgender people willing to participate in studies.

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Senior-Action7039 t1_ivbzsx1 wrote

I would hazard that the Trans patients started as Trans from birth as patients will admit they related to a different gender at a very young age. I would also hazard the comorbid mental health issues arise from exogenous and endogenous factors.I personally believe our current approach is lacking and more research is required.

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SerialStateLineXer t1_ivefck0 wrote

> Between April 2014 and January 2021, we administered semistructured diagnostic interviews for DSM-IV disorders to 2,212 psychiatric patients, 69 of whom reported TGD identity (ie, gender identity other than cisgender such as transgender, genderqueer, or nonbinary identity).

So the entire sample consists of psychiatric patients. I'm not sure what we can do with a finding like this, given the selection bias.

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