A comparison between transsexuality and transableism
Written by Marie on Tuesday, February 6, 2007
I recently asked someone to draw comparisons between being transexual and being transabled. This someone has personal experience with both conditions. She kindly wrote the following entry.
Part 1. Introduction and About the Author
Sean asked me to write something talking about the similarities in what a transsexual person and a transabled person go through. In fact Sean even coined the word "transabled" having in mind its similarities with transsexualism.
Personally I am a transsexual. I had GRS (genital reassignment surgery) in October 2005 with a well-recognised surgeon in North America. I am also transabled: I have a desire to be moderately/severely deaf (as journaled in my blog ‘makemedeaf.blogspot.com’). At the time of this writing I haven’t achieved my TA goal.
I’m hoping to make the similarities between transabledism (which may be a new word) and transsexualism so that more people can understand the transabled person. I am a very strong proponent of personal liberty and the rights of an individual to do what they want with their body, as long as it doesn’t hurt anyone nonconsenting.
Part 2. Definitions
A transsexual is a person that feels an incongruity between their genitals and their gender identity. A person’s gender identity is held in a person’s brain (as a part of "self"). Cisgendered (non-transsexual) individuals usually have a hard time understanding how something so fundamental such as one’s gender identity can be different from their genitals.
A transabled person is someone who desperately wants or needs to be disabled in some way. That’s taken straight from Sean’s glossary on transabled.org.
The transsexual and transabled person’s motivations are generally not sexual.
Part 3. Similarities
A transsexual feels that their body is different from the concept of self they have for theirself. That is to say that while they may outwardly appear to be female they actually are male. This is confusing for the transsexual and people around them since other people see a female and naturally assume that the person is female.
A transabled person is in a similar position. For example a person may have an identity of someone that is paralysed but is not actually paralysed. Any disability may be substituted in for paralysis such as blindness, amputee, deafness, ceberal palsy, AIDS, and so on.
In each case the problem at hand is the discongruity in self image from bodily reality.
Transbledism and transsexualism are often not well received by family members, society, and coworkers. They are both difficult for people who don’t experience them to understand. A quote from Karl A. Menninger illustrates what it’s like:
When a trout rising to a fly gets hooked on a line and finds himself unable to swim about freely he begins with a fight which results in struggles and splashes and sometimes an escape. Often, of course, the situation is too tough for him.
In the same way the human being struggles with his environment and with the hooks that catch him. Sometimes he masters his difficulties; sometimes they are too much for him. His struggles are all that the world sees and it naturally misunderstands them. It is hard for a free fish to understand what is happening to a hooked one.
In my transabled friends I notice more things similar with transsexualism: sometimes there’s a "purging" of both disability-related things (for the transabled) and gendered clothing (for the transsexual) in an attempt to ignore the feelings. Also, there is a sense that over time untreated feelings get progressively worse. This indicates that it is not likely that they may be ignored for very long.
Not all transsexuals have genital surgery. Some are content to use therapy to address their dysphoria, some use HRT to manage it and still some live as the desired role (with or without HRT). I speculate: While I don’t directly know anyone transabled that doesn’t want surgery to achieve their desired disability there must be some that are content to pretend or use therapy to manage their feelings. Surgery is not everyone’s goal.
Part 4. Dissimilarities
Research indicates that there is a congenital component to transsexuality. Post-mortum brain studies of male-to-female transsexuals have shown that they are more structurally similar to that of women than that of a male identified genetic male. A hypothesis is that around the 8th week of pregnancy when there is a ‘bath’ of testosterone on the fetus insufficient testosterone is present to masculinise the brain.
To the best of my knowledge there is no research to support a congenital component for BIID/transabledism.
[Note from Sean: There is no serious research into BIID, period. As such, there is no research to support congenital component, nor is there any research to disprove such a concept.]
Part 5. Transabled Standards of Care?
Transsexuals have a widely recognised and followed Standard of Care that prescribes the exact steps that a person must go through to begin transition. For example the SOC guidelines suggest that a person should be in therapy for three months before starting hormone replacement therapy (which, in a male-to-female transsexual replaces testosterone with oestrogen). The transsexual needs a letter from their therapist verifying that they are a transsexual and a good candidate for HRT.
The Standards of Care also require a transsexual to undergo a "real life test" in their desired role prior to recommending genital surgery. This includes changing the name and living socially and at work/school as a member of their desired gender. In addition to the RLT a transsexual needs the "approval" from a Ph.D psychologist or psychiatrist as well as a letter from their therapist before they may have surgery.
As you can see there are very well prescribed guidelines for transsexuals. I can’t see any specific reason why there can’t be a similar Standards of Care for transabled/BIID sufferers. What would it look like? Certainly I would expect a real life test of some duration wherein a person lives as a disabled person socially and at work/school. I would expect that before any surgeon would lift a scalpel they would want to see that the person had extensive therapy on topic and that their therapist(s) agreed that surgery was a viable and recommended treatment.
Part 6. The End (and a little editorial)
I’m a very liberal person and believe that there should be nothing to stop a person from doing whatever they want to their own body as long as it doesn’t hurt or involve a nonconsenting adult.
For a pointed example: a transabled person that wishes or feels a need to be deaf should be able to make him or herself deaf without reprecussion from the law. That person being deaf hurts no one. However if they wanted to make absolutely sure they heard no external noise they would want to sever the auditory nerve. This is not without implications: if they were wise they would realise that the vestibular nerve (for balance) and the auditory nerve are very close in proximity to each other and are therefor hard to separate. A consenting surgeon — this means that a surgeon is free to object to doing this surgery — might not be able to separate out the auditory bits from the vestibular bits and so the person may lose vestibular functionality from their inner ear. Or they could do no research and go into it blindly (which is a whole other example!).
The point is that I, as a person that wants to be deaf, should be legally and ethically free to achieve that deafness however I want. If I want to involve another person (such as a surgeon) we would need to come to an arrangement where we both consent to the procedure. The surgeon might not sever the nerves unless I illustrated an understanding of what will happen if I lose vestibular nerve function. Incidentally the medical community calls what the surgeon might ask (in my example) informed consent.
In a short one sentence summary: transsexuals and transabled people are more similar than one might think and they both deserve medical/psychological treatment – surgical if necessary.
For a scholarly article dealing with the ethics of amputation of healthy limbs read this PDF: Amputees By Choice: Body Integrity Identity Disorder and the Ethics of Amputation, TIM BAYNE, NEIL LEVY (2005) at: http://www.blackwell-synergy.com/links/toc/japp/22/1[tags]BIID, Transsexual, GID, Transabled, Standards+of+Care, Similarities[/tags]
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