gender "issues"

[rac1]

I am looking for articles, studies, books.... on the gender identity issues.

I had the Psychiatric Mental Health Nursing Success book from 2009, and it had chapters in it for gender identity "disorders." The updated newest version is retitled "issues related to sexuality."

As a provider of health care, I do not feel it is responsible of me to believe that gender identity issues are "normal," if in fact they are actually not. It seems to me this is a similar psychological issue as anorexia. The person feels fat, believes they are fat, does everything in their power to keep themselves from gaining weight - no one can convince them that they are not fat. We don't walk around pretending that they are normal. We tell them they need help. So I am struggling with the politics of these gender issues that are in the media, news, and within the healthcare community.

I have not studied, nor were we taught about this topic AT ALL in school. I know homosexuality used to be classified as a mental illness, and of course now it is not. I have read some articles that likened gender identity to homosexuality saying that being homosexual used to cause great distress and turmoil, and therefore it was classified as a mental illness, and so similarly this is why gender identity was classified as a mental illness.

Is it about the numbers? The more people that do it, means that it is actually NOT an illness? I mean, if more and more people start becoming anorexic, then it becomes okay, and not such a distressing life event..? Obviously there are physical implications that are different here, nonetheless...there are physical manifestations of any mental illness.

Trying to wrap my head around all of this and come to grips with providing good care and good mental health if/when I run into this growing population (or growing vocal population I should say).

Also, want to add, I am open to all sides of this. I do not judge people for the way they want to live. That is not my intent here at all. My goal is to provide the best care possible, but is it, or is it not a mental health issue..??

[elkpark]

Those are excellent question to pose. I imagine what it comes down to is another question. Which is "what is a detriment of health?" and then further, "what does this person think is a detriment of health?" Which is why this topic is confusing to me.

Most anorexic people do not believe, or care that they are harming themselves. I don't know if I can say "most", but a number anyway, or transgender people have a really difficult mental and emotional difficulty with what they believe. Is it societal imposed? Maybe, I'm not sure if that is bad, or good.

I believe the point Julius was making (not to put words in anyone's mouth, but how I read the post) is that untreated AN will kill you. I believe that is what was meant by "detrimental to the person's health." Being transgendered will not, by itself, result in your death (or even damage your general health). People can live long, healthy lives as transgendered people.

This topic isn't nearly as complicated or confusing as you've made it out to be. Being transgendered is not a mental illness. The psychiatric community that defines, for better or worse, what are considered psychiatric illnesses in our society has said that it's not.

[pixierose, BSN, RN]

First of all, I totally get that this is a hot topic, and I am coming toward it with an open mind because I am asking, to understand. To listen.

Next, I don't know that I said (or meant to imply) that "being trans causes mental illness." Moreso, my question was "is believing you're a different sex a mental illness." I still think that is a valid question. Because I believe it is a valid question - does not mean I believe anyone should think any person is less than human, that their identity is invalid, that they should cease to exist. And I certainly do not think it is okay to kill any*ONE*. Those behaviors are inexcusable. Treating a person poorly is just that...someone treating a person poorly. I don't believe my views harm you - I believe that my question is valid and scientific. If someone never question if narcissism was a psychiatric personality disorder, would that be okay? A narcissist could say all of the things that you said above. Would those words coming from them be just as valid as yours?

This is why I came to pose the question. Because I really don't know. What is the reason that it is not a psychiatric illness? Can you explain that to me? That is what I am looking for. What happened to a person that they feel like the opposite gender that every piece of DNA in their body assigned to them?

I think that my analogy was close, but I don't think it is perfect, by any means. I think people don't know WHAT to say to transgendered people. I mean, be honest. A person is born with the DNA that explains to us "FEMALE." But standing in front of me is a person that says "nope, I'm male." What do you expect us to think? To me, that IS similar to a person that is standing in front of me starving themselves to bone, and saying "Look at me. I'm fat. I feel fat." I would argue that transgenderism has similar tangible physical effects too, which causes extreme mental strain. So we could then say that anorexia is a society issue, could we not?

I would argue with you here too, because I read a study that explained that mental health issues, suicide rate and suicide ideation is extremely high in those that have transitioned. I believe it talked about the surgery relieving gender dysphoria, but not the mental health issues. I would agree that the social support system would improve that, but I am still not certain that we know whether or not this is or is not a mental health disorder. Where is the line? How do you draw the line? How do we "allow" or "disallow" people to really feel the way they feel inside. What about the people that believe they are animals, or African American? What about the anorexic people? Why shouldn't they be allowed to live that way? Why call it a disorder at all? Why not help them to feel mentally healthy in the lifestyle they feel happiest living?

I am not convinced that "trans people are the only experts on their own identity," as being the end of the sentence. I believe that they believe and that they are living inside a person they do not feel represents them. I am not wholly convinced that there is enough scientific evidence that it is not a mental disorder. But I am totally open to it.

I also believe that people hear voices telling them to do harmful things. I believe that the anorexic believes s/he's fat still. I believe the narcissist only understands his point of view. I believe that paranoid person really believes they cannot trust anyone.

None of these people are wrong. They really feel those feelings, and hear those things. Our brains are capable of a vast array of differences.

But I also would not say that they are fine to live that way their entire lives, although many can and do.

I do see how female child that feels like a male from say the age of 5....could have major mental, emotional (and physical) harm from a young age from society, especially family, and that the mental health aspect comes in that way.

But where is the evidence that shows that the 5 year old does NOT have a mental disorder believing s/he is the opposite sex? Where is that evidence? That is all I am asking.

I also do not mean to offend. I really asked this question because I want to know the answer. Thank you for taking your time to share.

"What do you expect us to think?"

Us? Please don't lump me in this position.

Being transgendered is not, I repeat, is NOT a mental illness.

That you're comparing anorexia to being transgendered is so beyond ridiculous, it's insanity. Or comparing this to people wanting to become animals? People hearing voices to harm another and the anorexic are detrimental to ones' health. Being transgendered is NOT.

It becomes detrimental to ones' health after posts like this. After views like this.

I feel sick.

[Julius Seizure]

I believe the point Julius was making (not to put words in anyone's mouth, but how I read the post) is that untreated AN will kill you. I believe that is what was meant by "detrimental to the person's health." Being transgendered will not, by itself, result in your death (or even damage your general health). People can live long, healthy lives as transgendered people.

This topic isn't nearly as complicated or confusing as you've made it out to be. Being transgendered is not a mental illness. The psychiatric community that defines, for better or worse, what are considered psychiatric illnesses in our society has said that it's not.

You understood my point perfectly, elkpark.

I noticed today that the hospital EMR system at work has been updated, and the demographics bar at the top of the page no longer says just age, sex, date of birth, etc. It now includes "gender identity", "sex assigned at birth", and "preferred pronouns". I think that it is a fantastic improvement, and I hope that staff take note of it and actually use the info to improve care for the patient (rather than just as an item to gossip about).

[Nimrodel, BSN, RN]

You claim to be open to other viewpoints and professional opinions, and yet your words very clearly indicate that you have made up your opinion and don't care who you harm by having that opinion. I'm out.

[deliriumtrigg3r]

Totally right there with you. I want to provide the best care possible to my patients, and of course many of them are trans these days. But yes, I do wonder what makes believing you're a man when you're biologically a woman NOT a mental illness in the way that believing you are a different person or an animal does. One patient thought she was a cat. For real. Really just looking for answers here, not trying to trigger anyone. I have seen cases of a woman wanting amputations because she believed that was an expression of her true self. Also, those with cotards syndrome believe they lack organs... are these mental illness or should we encourage and normalize these?

[hppygr8ful, ASN, RN, EMT-I]

As a person who was raised with very conservative ideals I have to say that I have made a complete turn around from where I started when I became a nurse. I did my own research and talked to a lot of people from the LGBTQ community. I found that they are people just like we are they have two legs, two arms etc... They think and feel the same way so called "normal people" think and feel. Some seem far more mentally healthy than the straight folks I know. I don't really like labeling people.

[deliriumtrigg3r]

It's not about labeling people... I think "transgender" or "heterosexual" are labels. We are wondering why it is not considered a mental illness to cut off body parts and take dangerous and unnecessary hormones in a war against Your often healthy body. I thought this was a psych nursing thread? Other patients believe to be something they are not, and it is just considered a delusion or part of a disease. Many patients believe they are dead... it's considered mental illness.

[deliriumtrigg3r]

Not to mention the way all these hormones helping to "transition" are known to make people act "crazy".

[pixierose, BSN, RN]

This thread is just ... appalling. How a health professional, a psych nurse(s) no less, can have these harmful attitudes ... disgusting.

I have a lot more to say but they'd be against TOS.

I'm out.

[deliriumtrigg3r]

Harmful attitudes? Not really.... but it is a big deal to start that transition, and the result isn't always better mental health.

[traumaRUs, MSN, APRN]

STAFF NOTE - this is a hot topic. Per our terms of service, debate is allowed but please remain respectful.

[canoehead, BSN, RN]

I think that if I had been born with male parts, I would have lived my life as a male, and not had any conflict about it. I had trouble understanding the need to dress and act like the opposite sex, and get surgery to become male or female when someone was born the opposite gender. I don't get it. I don't get climbing Everest either, but I've heard people put their jobs, relationships and their very lives on the line to do it...and then they go back and do it AGAIN. No one calls them mentally ill.

So my conclusion was that I need to respect decisions that others have made about their own lives and identities. Trans folks go through hell to be who they want to be, and who am I to undermine them or disrespect? They think the transition is worth the pain of hormones, surgery, and general meanness from others, and I see their commitment. I want to support them- they are on a tough road. I don't get it, but I don't have to get it, it's their life, not mine.

For those generally against trans folks, or homosexuals, or choose your predjudice- you can think someone is batcrap crazy for climbing Everest, or choosing divorce instead of sticking it out, or buying Toyota instead of Ford, but that doesn't make them mentally ill. Some of the replies made me think we have a disagreement in personal values rather than a discussion about illness.