I decided recently that I should apply for membership of the British Psychological Society. I have a valid degree to apply for graduate membership, and the recent business at the APA over the DSM-V categorisation of Gender Incongruence shows that psychology, as a science, needs people who can think beyond the binary. Ironically, one of my favourite webcomics has recently provided an indication of why this is the case.
XKCD is a webcomic produced by Randall Munroe. Munroe comes from a scientific background, having worked as a contractor for NASA, and often includes geeky, science-based humour in the strip. He's also currently conducting some kind of research into colour blindness, and has included a survey on colour-blindness on his site.
If you've been following this blog awhile, you'll have worked out what's annoyed me. It's this question:
Do you have a Y chromosome?
If unsure, select "Yes" if you are physically male and "No" if you are physically female. If you have had SRS, please respond for your sex at birth. This question is relevant to the genetics of colorblindness.
What's particularly annoying about this is the fact that Munroe is clearly trying to be gender-inclusive, bless him. And I can sort of see why you might want to know the birth gender of people who are colour-blind, if you're studying the genetics of the condition. But...the fail. It burns.
It burns for a lot of reasons. Mainly because it's more complicated than that. Munroe doesn't allow for intersex people: by reducing 'physical maleness' to the matter of having a Y-chromosome, he excludes men with Klinefelter's syndrome (on which note check out Helen from Bird of Paradox's post about KS Awareness Week), who have a Y chromosome, it's true, but also have an extra X chromosome, and are less 'physically male' than the generic-model XY-guy. He excludes those people with tetragametic chimerism who can have XX and XY chromosome structures in different parts of their bodies. And he is of course tremendously hurtful to trans people by reducing the issue of their gender to what chromosomes they were born with.
I don't think that this was deliberate on Munroe's part. He's mentioned people who've had SRS, he's tried to frame the question not as 'are you male or female?' but 'do you have a Y-chromosome?' He's tried. This isn't the kind of Cisfail the Guardian, say, engage in when they run columns about trans people and queerness by folk like Julie Bindel or Bea Campbell. But he's got the whole thing bloody wrong. Not just ethically, in fact, but methodologically.
Because the thing is, doing a survey on the internet, in which anyone can take part, is a lousy way to carry out research. You'll get lots of responses, but how do you know those responses are the same people? How do you know which participants make up your sample? The data at the start of the survey are meaningless because - and I'm gonna rock you in your socks here, people - the internet lies. Anyone (i.e. me) could go on Munroe's survey, and claim to be, say, a colourblind Frenchwoman in possession of a genuine Y-chromosome, and then proceed to answer the survey by, say, giving the colours increasingly ridiculous names. This happens when you do research. One of my old psych lecturers said that psychology experiments are tainted, for the most part, because the samples they usually use are made up of psychology students, and usually most of those students will either (a) be nice students trying to 'help' you get the result you 'want' or (b) evil little feckers (i.e. me, again) deliberately trying to give answers which will give you the result you don't 'want.' So, y'know, doing a survey on the internet in which anyone can participate is methodologically unsound from the get-go. So why ask an offensive question in the first place?
It'll get lots more responses, that's certain. But a more tightly controlled research project carried out among a smaller participant population would yield better quality data from participants who could be much better described. As it is, Munroe's survey is basically an open invitation to people to lie about their gender, about whether or not they're colourblind, about what country they're from (and we've noticed the annoying 'Tell us your native language, but answer questions in English' question, haven't we?) and so on, and then to 'answer' the survey by calling the colours things like 'Jan Vermeer's Pannetone Cyclotron', 'Grrr-nommy-nomminy' and 'the mongspoddler'. Not that I would endorse such behaviour (which may or may not have been carried out by me).
The fact is that, frankly, trans people, as much as we might wish it otherwise, are such a statistically small section of the population (yes, even on the internet) that, unless you're actually doing research on the trans community (and research in such a sensitive area should come with very specialised ethical requirements), it isn't worth controlling for the possibility of trans men and women answering your survey. Munroe could easily get away with asking the question 'Are you male or female?' safe in the knowledge that most of his results will come from cis people, and that any statistical patterns relating to biological gender will be easily apparent in the data. To get into discussion of chromosomes, to talk of being 'physically male' or 'physically female' and to ask trans people to give their birth gender (therefore reminding them of their status in some bigots' eyes as not real women or men, with all the traumatic memories that will trigger) is both unnecessary and irresponsible. It's bad science, in both senses of the word. And, coming from the creator of a strip who's so often found humour in mocking other peoples' scientific errors, it's a depressing thing to see.
As any scientist will tell you, the biggest part of the job is asking the right questions. Munroe has tried to ask the right question in his survey, but he's tried too hard: and when he finds himself toiling through page after page of deliberately buggered-up results, he'll only have himself to blame.
Showing posts with label psychology. Show all posts
Showing posts with label psychology. Show all posts
Monday, 15 March 2010
Saturday, 6 March 2010
'It's not Number One who will come out alive: it's the freak in the corner with his eyes on fire.'
The ever-reliable Charlie Brooker speaks some Strong Truth in his TV review for today's Grauniad: 'One of life's sorest tragedies is that the people who brim with confidence are always the wrong people.' (emphasis mine)
A sore tragedy indeed, and one to which I've been giving a lot of thought in the past few weeks. Having found myself unemployed at the end of last year, then making the rounds of job interviews at various places, before securing a job in my current workplace and trying to fit in (and then deciding not to bother trying to fit in) with a new bunch of people, I've been thinking about that elusive beast we call 'confidence' or 'self-esteem' or 'self-worth', or whatever. You know the kind of thing I mean: the can-do, go-getting, utterly sickening attitude of the kinds of prick (and very often the kind of person displaying this behaviour is in possession of a prick, and disgustingly comfortable being so) who truly, honestly believe there's nothing they can't do. The kind of scumbag who winds up on the Apprentice or the other tawdry 'reality' programmes in which gangs of gurning halfwits are pressed into performing moronic tasks for the amusement of Space Raider-chomping never-weres. Those feckers.
The weird thing I've noticed is that, whether on reality TV or in the global marketplace (remember all those smug assurances that the credit bubble wouldn't burst for another billion years?), the confident bastards always fail. This shouldn't be that surprising, psychologically speaking. And it hasn't been surprising for over twenty years. In 1989, Cornell University psychologists Justin Kruger and David Dunning conducted research which proves, essentially, that the more confident you are of being able to perform a task effectively, the more likely you are to fail. Conversely, truly effective people usually underestimate their performance. Other research has found that trying to boost peoples' self-esteem has no effect on academic improvement, and that employing people with high self-esteem can often be a risky decision because, when their ego is threatened, they usually fuck up. The evidence is there, and has been there for two decades, that recruiting and promoting people on the basis of their being super-mega-confident is an incredibly stupid thing to do. And yet, we continue to live in a world that, as I said yesterday, rewards confidence over actual achievement. Why?
Well, one reason is probably that people in the business world have a very poor understanding of genuine psychology. It amused the hell out of me, during training at my new place, to have to answer yet another bloody VAK questionnaire based on the now mostly discredited pseudo-science of Neuro-Linguistic Programming, but the lack of willingness on the part of business to use genuine personality measures in categorising their staff is a pretty serious matter. If you can't classify staff properly you risk recruiting the wrong people, deploying those people to the wrong areas and, ultimately failing spectacularly, dragging your profits, and maybe even your company, down in flames. But valid and reliable personality measures are difficult to administer. You need qualified technicians to administer and interpret them. They take a while to complete. You need to pay for the tests, and you need to pay the technicians for their hard work as well. This is discouraging to many businesses, but the bald fact is that you get what you pay for. Most personality measures used by companies today are basically no more valid or reliable than a Cosmo questionnaire. If you answered mostly As, Bs or Cs, you're an idiot and your company is fucked.
There is, of course, another reason why people in privileged positions continue to reward confidence, though, and that reason is privilege itself. Basically, the more privileged you are, the more confident you are likely to feel. Remember that privilege can take many forms. Men have privilege over women; cis people have privilege over trans people; whites have privilege over people from other races; able-bodied people have privilege over disabled people, and so on. These oppressions can and do intersect, and people who lack privilege in one way may still have privilege over other groups, and may still abuse it (a good example of this would be the way a lot of cis gay people, who lack hetero privilege, are perfectly happy to exert privilege over trans people, often in hateful and exclusionary ways).
When you look at people in the top positions in industry, you see that, despite decades of equality activism, they still tend to be able-bodied, cis gender, heterosexual caucasian males. Despite the bleatings of the Daily Mail tendency, the archetypal black lesbian in a wheelchair decidedly does not get it all her own way (though if I worked in recruitment I'd hire a black lesbian in a wheelchair in a heartbeat. Imagine having to contend with racism and homophobia and ableism on a daily basis. She'd be hard as fucking nails.). And the reason for this is that we recruit, especially for higher-level positions, on the basis of confidence. And not just confidence in job interviews, but in the business environment. In the office. At the social events. At the squash club. Down the pub. We hire and promote people who exude confidence, who seem like 'good blokes' and walk with a swagger (though we only reward swaggering in people who are like us. Swagger as a member of a minority group and just wait to be accused of being 'uppity'. It won't take long.).
And by rewarding confidence, we reward privilege. People who lack privilege, people who are marginalised by society, have to contend with being reminded of their lack of privilege on a daily basis. (Don't believe me? Think I'm being needlessly 'politically correct'? Read The Invisible Knapsack, or one of its many variants unpacking heterosexual, cis or other forms of privilege.) You are constantly told, in ways both subtle and unsubtle, that you don't belong. That you aren't worthy. This is bound to make it harder to feel confident in yourself. Conversely, if you are privileged, the world goes out of its way to reinforce your confidence. Most of the rich, famous, celebrated people look like you. You can drink where you want, you can sit anywhere you want on the bus, you have no problem flagging down a cab. This is bound to make you feel more confident in yourself.
To put it bluntly, then: rewarding confidence is a way in which privileged people can reward and promote each other on the basis of privilege, without seeming to. They themselves may not even be conscious that they're doing it. But it's discrimination all the same. It's also actively harmful to businesses, because confident people are more likely to fuck up; and, because people with lower self-esteem actually seem to do better in challenging situations, it actually leads to us ignoring a vast wealth of ability, skills and experience which could help pull us out of the economic hellhole smug, confident, privileged people have dragged us all into. It needs to stop.
I'm not holding my breath, though. And, before I go, one final word on self-esteem. There is a way in which those of us who lack privilege can make our self-esteem stronger than that of the privileged. Most privileged people derive their self-esteem from their position in the hierarchy, from being 'top of the heap.' This is not a very strong basis on which to build your self-esteem, and that's why, as in the Baumeister paper I linked to above, it basically crumbles and leads to EPIC FAIL when it encounters an ego threat. If you lack privilege on one axis of the kyriarchy but have it on another, you could follow the 'kiss up, kick down' strategy of picking on groups below you, but this still leads to the same weakness: as soon as you encounter ego threat, you'll fuck up. Or, you could do the smart thing, and base your self-esteem not on your hierarchical position, but on your achievements. Doing this means you have a firmer, more realistic basis on which to build your self-confidence, which gives you a better chance of handling ego-threat scenarios. Privileged people don't like to do this because it's hard work and, hey, why bother when you can just sneer at the outcasts? But it pays dividends when the chips are down. And it's one way in which people who lack privilege have a head-start, because if you base your self-esteem on achievements rather than position, by negotiating the daily challenges of a world which tries to disadvantage you in a million different ways, you've already achieved something great.
And, in facing a world which rewards privilege and marginalises those who lack it, it's important to keep your self-confidence up as an act of resistance to the kyriarchy. And if you are privileged, then you could maybe stop repeating your affirmations into the mirror and listen to the quiet, freakish people in the corner of the office for a change. They might have some ideas of a little more relevance to your business than what England need to do to win the world cup, or what you'd like to do to Cheryl Cole now she's single again. To sum it up: for the marginalised, self-esteem management is self-defence; for the privileged, self-aggrandisation is self-abuse. And we all know what happens when you do too much of that.
A sore tragedy indeed, and one to which I've been giving a lot of thought in the past few weeks. Having found myself unemployed at the end of last year, then making the rounds of job interviews at various places, before securing a job in my current workplace and trying to fit in (and then deciding not to bother trying to fit in) with a new bunch of people, I've been thinking about that elusive beast we call 'confidence' or 'self-esteem' or 'self-worth', or whatever. You know the kind of thing I mean: the can-do, go-getting, utterly sickening attitude of the kinds of prick (and very often the kind of person displaying this behaviour is in possession of a prick, and disgustingly comfortable being so) who truly, honestly believe there's nothing they can't do. The kind of scumbag who winds up on the Apprentice or the other tawdry 'reality' programmes in which gangs of gurning halfwits are pressed into performing moronic tasks for the amusement of Space Raider-chomping never-weres. Those feckers.
The weird thing I've noticed is that, whether on reality TV or in the global marketplace (remember all those smug assurances that the credit bubble wouldn't burst for another billion years?), the confident bastards always fail. This shouldn't be that surprising, psychologically speaking. And it hasn't been surprising for over twenty years. In 1989, Cornell University psychologists Justin Kruger and David Dunning conducted research which proves, essentially, that the more confident you are of being able to perform a task effectively, the more likely you are to fail. Conversely, truly effective people usually underestimate their performance. Other research has found that trying to boost peoples' self-esteem has no effect on academic improvement, and that employing people with high self-esteem can often be a risky decision because, when their ego is threatened, they usually fuck up. The evidence is there, and has been there for two decades, that recruiting and promoting people on the basis of their being super-mega-confident is an incredibly stupid thing to do. And yet, we continue to live in a world that, as I said yesterday, rewards confidence over actual achievement. Why?
Well, one reason is probably that people in the business world have a very poor understanding of genuine psychology. It amused the hell out of me, during training at my new place, to have to answer yet another bloody VAK questionnaire based on the now mostly discredited pseudo-science of Neuro-Linguistic Programming, but the lack of willingness on the part of business to use genuine personality measures in categorising their staff is a pretty serious matter. If you can't classify staff properly you risk recruiting the wrong people, deploying those people to the wrong areas and, ultimately failing spectacularly, dragging your profits, and maybe even your company, down in flames. But valid and reliable personality measures are difficult to administer. You need qualified technicians to administer and interpret them. They take a while to complete. You need to pay for the tests, and you need to pay the technicians for their hard work as well. This is discouraging to many businesses, but the bald fact is that you get what you pay for. Most personality measures used by companies today are basically no more valid or reliable than a Cosmo questionnaire. If you answered mostly As, Bs or Cs, you're an idiot and your company is fucked.
There is, of course, another reason why people in privileged positions continue to reward confidence, though, and that reason is privilege itself. Basically, the more privileged you are, the more confident you are likely to feel. Remember that privilege can take many forms. Men have privilege over women; cis people have privilege over trans people; whites have privilege over people from other races; able-bodied people have privilege over disabled people, and so on. These oppressions can and do intersect, and people who lack privilege in one way may still have privilege over other groups, and may still abuse it (a good example of this would be the way a lot of cis gay people, who lack hetero privilege, are perfectly happy to exert privilege over trans people, often in hateful and exclusionary ways).
When you look at people in the top positions in industry, you see that, despite decades of equality activism, they still tend to be able-bodied, cis gender, heterosexual caucasian males. Despite the bleatings of the Daily Mail tendency, the archetypal black lesbian in a wheelchair decidedly does not get it all her own way (though if I worked in recruitment I'd hire a black lesbian in a wheelchair in a heartbeat. Imagine having to contend with racism and homophobia and ableism on a daily basis. She'd be hard as fucking nails.). And the reason for this is that we recruit, especially for higher-level positions, on the basis of confidence. And not just confidence in job interviews, but in the business environment. In the office. At the social events. At the squash club. Down the pub. We hire and promote people who exude confidence, who seem like 'good blokes' and walk with a swagger (though we only reward swaggering in people who are like us. Swagger as a member of a minority group and just wait to be accused of being 'uppity'. It won't take long.).
And by rewarding confidence, we reward privilege. People who lack privilege, people who are marginalised by society, have to contend with being reminded of their lack of privilege on a daily basis. (Don't believe me? Think I'm being needlessly 'politically correct'? Read The Invisible Knapsack, or one of its many variants unpacking heterosexual, cis or other forms of privilege.) You are constantly told, in ways both subtle and unsubtle, that you don't belong. That you aren't worthy. This is bound to make it harder to feel confident in yourself. Conversely, if you are privileged, the world goes out of its way to reinforce your confidence. Most of the rich, famous, celebrated people look like you. You can drink where you want, you can sit anywhere you want on the bus, you have no problem flagging down a cab. This is bound to make you feel more confident in yourself.
To put it bluntly, then: rewarding confidence is a way in which privileged people can reward and promote each other on the basis of privilege, without seeming to. They themselves may not even be conscious that they're doing it. But it's discrimination all the same. It's also actively harmful to businesses, because confident people are more likely to fuck up; and, because people with lower self-esteem actually seem to do better in challenging situations, it actually leads to us ignoring a vast wealth of ability, skills and experience which could help pull us out of the economic hellhole smug, confident, privileged people have dragged us all into. It needs to stop.
I'm not holding my breath, though. And, before I go, one final word on self-esteem. There is a way in which those of us who lack privilege can make our self-esteem stronger than that of the privileged. Most privileged people derive their self-esteem from their position in the hierarchy, from being 'top of the heap.' This is not a very strong basis on which to build your self-esteem, and that's why, as in the Baumeister paper I linked to above, it basically crumbles and leads to EPIC FAIL when it encounters an ego threat. If you lack privilege on one axis of the kyriarchy but have it on another, you could follow the 'kiss up, kick down' strategy of picking on groups below you, but this still leads to the same weakness: as soon as you encounter ego threat, you'll fuck up. Or, you could do the smart thing, and base your self-esteem not on your hierarchical position, but on your achievements. Doing this means you have a firmer, more realistic basis on which to build your self-confidence, which gives you a better chance of handling ego-threat scenarios. Privileged people don't like to do this because it's hard work and, hey, why bother when you can just sneer at the outcasts? But it pays dividends when the chips are down. And it's one way in which people who lack privilege have a head-start, because if you base your self-esteem on achievements rather than position, by negotiating the daily challenges of a world which tries to disadvantage you in a million different ways, you've already achieved something great.
And, in facing a world which rewards privilege and marginalises those who lack it, it's important to keep your self-confidence up as an act of resistance to the kyriarchy. And if you are privileged, then you could maybe stop repeating your affirmations into the mirror and listen to the quiet, freakish people in the corner of the office for a change. They might have some ideas of a little more relevance to your business than what England need to do to win the world cup, or what you'd like to do to Cheryl Cole now she's single again. To sum it up: for the marginalised, self-esteem management is self-defence; for the privileged, self-aggrandisation is self-abuse. And we all know what happens when you do too much of that.
Friday, 5 March 2010
You've Got Ray Blanchard In A Whirl...
My last post, about my dissatisfaction with the inclusion of 'Autogynephilia' as a diagnostic category in DSM-V has caused some controversy on Twitter, which I feel I should address here. What I specifically want to address is the accusation that I don't believe Autogynephilia is 'real'.
The reality, of course, is more complex than that. The thing about psychiatric diagnoses is that they are harder to arrive at than biological ones. Klinefelter's Syndrome is comparatively easy to diagnose: either your karyotype indicates you have an extra X chromosome or it doesn't. Gender Identity Disorder - soon, gods and goddesses willing, to be reclassified as Gender Incongruence - is a more nuanced diagnosis to make, depends on a lot of factors, and can be experienced differently by different people.
The reason for this is that psychiatrists and psychologists, in classifying mental disorders, are dealing not so much with specific viruses or bacteria, but more nebulous collections of symptoms. Many of the symptoms occur together and often react well to certain forms of clinical intervention. Where this happens it is usual to apply a diagnostic label to the collection of symptoms in order to aid the treatment of individuals who present with them in the future. But the labels we apply to these collections of symptoms are always subject to change, as are the symptoms which fall under a certain label. For example, schizophrenia as we know it has developed over a curious course of diagnostic evolution from its original classification as 'dementia praecox' to the clinical definition we know today. Currently, moves are afoot to eliminate Asperger's Syndrome as a separate condition and merge it with the other Autism Spectrum Disorders, on the grounds that it fits in better on that spectrum than as a separate entity. All this is as it should be: research modifies our understanding of a condition, which in turn modifies the way we categorise it, which in turn leads to improvements in the ways we treat or help people deal with these conditions.
In a perfect world this is how it would always work, but this world is far from perfect, and, despite vast efforts to build in a system of checks, balances and controls, psychologists and psychiatrists are at least as likely as people in the general population to have prejudices and biases, and these biases can and do creep into the disciplines themselves. This is one reason why periodic revision of the DSM is a good idea: it allows for reevaluation of the previously accepted psychological norms.
'The normal' itself is, of course, one of the biggest biases that can creep into diagnosis. I mentioned in my previous piece that, for a long time, homosexuality was considered a psychiatric 'disorder' because it was regarded as 'abnormal.' Thankfully, these days it is accepted that this isn't the case. But psychiatry persists in categorising some sexualities as normal and others as not so. The device used for this purpose is the idea of 'paraphilia' or, in layman's terms, sexual fetishism.
Paraphilia, as a diagnosis, has its uses, in that it provides a useful framework for considering the sexual desires of people whose behaviour is genuinely harmful, such as paedophiles and sex murderers. You'll note that the DSM-IV definition talks of non-normative sexual behaviours which 'may cause distress or serious problems for the paraphiliac or other persons associated with him or her'. But, notice the may. Something doesn't have to be causing anyone harm to be considered a paraphilia. Your kink might be pretty innocuous - maybe you have a thing for being shagged on formica tables, or you like to masturbate while listening to Vaughan Williams' Fantasia on a Theme of Thomas Tallis. You're not harming anyone (unless you go to a concert hall to pleasure yourself), but it doesn't matter. You have a paraphilia. You have a disorder. You are, as they say, in the system.
Look: I've known some kinky people. Hell, I'm pretty kinky myself (you don't want to know what I want Girl Obelix to do to me), and none of the kinky people I've met seemed mentally ill. Some had other mental illnesses, such as depression, but no more than in the general population, by my reckoning. And where there did seem to be a link between their particular pastime and some level of, say, depression or alcoholism, this could always be understood as a reaction to their marginalised status, and the prejudice they suffered from people with more privileged 'normal' sexualities.
I'm coming to understand that the social construction of mental disorders, which seemed like a purely theoretical idea when I first studied psychology, is a reality. To say disorders are socially constructed does not mean they aren't 'real.' Rather, it's the case that when people fall outside social norms, the response of people in society to their behaviour actively constructs their disorder. Consider the paradigm that has recently emerged in the field of disability activism: people are not disabled in themselves, they are disabled by a society which creates obstacles to their effective functioning, to the benefit of the privileged. Without wanting to come across as entirely RD Laing, I don't think it's too much of a leap to say that many people we class as 'disordered' actually reflect the disordered state of society.
Gender Incongruence is a real thing which people experience, and which can be treated with a variety of methods, up to and including gender reassignment surgery. But it only becomes a disorder because it conflicts with the social expectations a society places on someone because of their birth gender, and failing to meet those expectations causes feelings of trauma and guilt. Most sexual fetishes only become disorders when the treatment of people who happen to enjoy such fetishes leads to their experiencing feelings of marginalisation and low self-worth.
This applies even to those disorders considered to have a strong physiological basis. Depression seems to be the result of chemical imbalances in the brain (given that it often responds to treatment using chemicals which correct said imbalances). However, depression as a disorder, rather than a normal, acceptable and managable part of human diversity, is constructed by a society which unduly rewards self-confidence and bonhomie over actual achievement (there'll be more on this in my next post, which will consider the issue of privilege and self-esteem in greater depth).
So, to return to Autogynephilia, here we have a definition of something which could easily be classed as Gender Incongruence, but isn't because some cis male psychologists have decided that the only real gender incongruence is heterosexual in nature. If you're a trans woman and you want to fuck men, Roberta's your auntie. But if you're male assigned at birth, feel gender incongruence, but want to get it on with other ladies...that's not real Gender Incongruence. That's just a paraphilia. That's just sexual deviancy (don't worry if you're a trans man who wants to fuck other fellas, though. Ray Blanchard doesn't consider gay trans men in his definition of Autogynephilia. Perhaps, like Queen Victoria on lesbians, he doesn't think they really exist).
I cannot see the logic in this distinction. As far as I can work it out, Gender Incongruence is the same regardless of who you want to bump uglies with, because, well, Gender Congruence is the same, regardless of who you want to bump uglies with. So 'Autogynephilia' can only be a socially constructed 'disorder' based on the heteronormative, cissupremacist prejudices of our society. But it isn't just a bad diagnosis. It's actively harmful.
Many transphobes today persist in regarding being trans as a 'lifestyle choice'. By creating a false division which says one type of Gender Incongruence is real, but one is just a 'perversion', the deployment of Autogynephilia as a diagnostic category legitimises this perception. It makes psychologists and psychiatrists complicit in the marginalisation of people who are already heavily marginalised by society. This is a deep betrayal of psychology's basis as a science, and psychiatry's basis as a branch of medicine. The purpose of science is to describe reality objectively, free from the biases and prejudice of phenomenologically lazier forms of discourse. The purpose of medicine is to heal those who are hurting, without harming them further.
'Autogynephilia' does not meet either of these requirements. It is scientifically unnecessary: everything it involves could easily be described in terms of Gender Incongruence. And it is medically abhorrent, as it leaves people who form a normal, healthy part of the gender spectrum with the idea that they are somehow 'wrong', with no possibility of cure, and causes them further harm by legitimising the prejudiced views that they're all just perverts.
None of this means that there are not birth-gendered men who identify as female in a primarily sexual context. For some of these people it is just a fetish, either cross-dressing or enforced feminization. That's fine. For some it goes deeper. There are also, of course, trans women who aren't very sexual. And there are trans women who are very sexual, and trans men of all kinds too. The gender spectrum is just that, a spectrum, on which there are many varieties of experience. This is a concept bourne out by the experiences of people in the trans community and their cis allies every day, but it's a concept which still meets with resistance from the more bigoted sectors of the population. The job of psychologists is to break down this bigotry by revealing the truth about the human psyche. The job of psychiatrists is to help those who are harmed by such bigotry. So the message to the people compiling the DSM-V should be clear: focus on a more inclusive, but still robust, definition of Gender Incongruence, chuck 'Autogynephilia' on the scrap heap with dementia praecox and sexual inversion, and do your bloody jobs. It's what you're there for.
The reality, of course, is more complex than that. The thing about psychiatric diagnoses is that they are harder to arrive at than biological ones. Klinefelter's Syndrome is comparatively easy to diagnose: either your karyotype indicates you have an extra X chromosome or it doesn't. Gender Identity Disorder - soon, gods and goddesses willing, to be reclassified as Gender Incongruence - is a more nuanced diagnosis to make, depends on a lot of factors, and can be experienced differently by different people.
The reason for this is that psychiatrists and psychologists, in classifying mental disorders, are dealing not so much with specific viruses or bacteria, but more nebulous collections of symptoms. Many of the symptoms occur together and often react well to certain forms of clinical intervention. Where this happens it is usual to apply a diagnostic label to the collection of symptoms in order to aid the treatment of individuals who present with them in the future. But the labels we apply to these collections of symptoms are always subject to change, as are the symptoms which fall under a certain label. For example, schizophrenia as we know it has developed over a curious course of diagnostic evolution from its original classification as 'dementia praecox' to the clinical definition we know today. Currently, moves are afoot to eliminate Asperger's Syndrome as a separate condition and merge it with the other Autism Spectrum Disorders, on the grounds that it fits in better on that spectrum than as a separate entity. All this is as it should be: research modifies our understanding of a condition, which in turn modifies the way we categorise it, which in turn leads to improvements in the ways we treat or help people deal with these conditions.
In a perfect world this is how it would always work, but this world is far from perfect, and, despite vast efforts to build in a system of checks, balances and controls, psychologists and psychiatrists are at least as likely as people in the general population to have prejudices and biases, and these biases can and do creep into the disciplines themselves. This is one reason why periodic revision of the DSM is a good idea: it allows for reevaluation of the previously accepted psychological norms.
'The normal' itself is, of course, one of the biggest biases that can creep into diagnosis. I mentioned in my previous piece that, for a long time, homosexuality was considered a psychiatric 'disorder' because it was regarded as 'abnormal.' Thankfully, these days it is accepted that this isn't the case. But psychiatry persists in categorising some sexualities as normal and others as not so. The device used for this purpose is the idea of 'paraphilia' or, in layman's terms, sexual fetishism.
Paraphilia, as a diagnosis, has its uses, in that it provides a useful framework for considering the sexual desires of people whose behaviour is genuinely harmful, such as paedophiles and sex murderers. You'll note that the DSM-IV definition talks of non-normative sexual behaviours which 'may cause distress or serious problems for the paraphiliac or other persons associated with him or her'. But, notice the may. Something doesn't have to be causing anyone harm to be considered a paraphilia. Your kink might be pretty innocuous - maybe you have a thing for being shagged on formica tables, or you like to masturbate while listening to Vaughan Williams' Fantasia on a Theme of Thomas Tallis. You're not harming anyone (unless you go to a concert hall to pleasure yourself), but it doesn't matter. You have a paraphilia. You have a disorder. You are, as they say, in the system.
Look: I've known some kinky people. Hell, I'm pretty kinky myself (you don't want to know what I want Girl Obelix to do to me), and none of the kinky people I've met seemed mentally ill. Some had other mental illnesses, such as depression, but no more than in the general population, by my reckoning. And where there did seem to be a link between their particular pastime and some level of, say, depression or alcoholism, this could always be understood as a reaction to their marginalised status, and the prejudice they suffered from people with more privileged 'normal' sexualities.
I'm coming to understand that the social construction of mental disorders, which seemed like a purely theoretical idea when I first studied psychology, is a reality. To say disorders are socially constructed does not mean they aren't 'real.' Rather, it's the case that when people fall outside social norms, the response of people in society to their behaviour actively constructs their disorder. Consider the paradigm that has recently emerged in the field of disability activism: people are not disabled in themselves, they are disabled by a society which creates obstacles to their effective functioning, to the benefit of the privileged. Without wanting to come across as entirely RD Laing, I don't think it's too much of a leap to say that many people we class as 'disordered' actually reflect the disordered state of society.
Gender Incongruence is a real thing which people experience, and which can be treated with a variety of methods, up to and including gender reassignment surgery. But it only becomes a disorder because it conflicts with the social expectations a society places on someone because of their birth gender, and failing to meet those expectations causes feelings of trauma and guilt. Most sexual fetishes only become disorders when the treatment of people who happen to enjoy such fetishes leads to their experiencing feelings of marginalisation and low self-worth.
This applies even to those disorders considered to have a strong physiological basis. Depression seems to be the result of chemical imbalances in the brain (given that it often responds to treatment using chemicals which correct said imbalances). However, depression as a disorder, rather than a normal, acceptable and managable part of human diversity, is constructed by a society which unduly rewards self-confidence and bonhomie over actual achievement (there'll be more on this in my next post, which will consider the issue of privilege and self-esteem in greater depth).
So, to return to Autogynephilia, here we have a definition of something which could easily be classed as Gender Incongruence, but isn't because some cis male psychologists have decided that the only real gender incongruence is heterosexual in nature. If you're a trans woman and you want to fuck men, Roberta's your auntie. But if you're male assigned at birth, feel gender incongruence, but want to get it on with other ladies...that's not real Gender Incongruence. That's just a paraphilia. That's just sexual deviancy (don't worry if you're a trans man who wants to fuck other fellas, though. Ray Blanchard doesn't consider gay trans men in his definition of Autogynephilia. Perhaps, like Queen Victoria on lesbians, he doesn't think they really exist).
I cannot see the logic in this distinction. As far as I can work it out, Gender Incongruence is the same regardless of who you want to bump uglies with, because, well, Gender Congruence is the same, regardless of who you want to bump uglies with. So 'Autogynephilia' can only be a socially constructed 'disorder' based on the heteronormative, cissupremacist prejudices of our society. But it isn't just a bad diagnosis. It's actively harmful.
Many transphobes today persist in regarding being trans as a 'lifestyle choice'. By creating a false division which says one type of Gender Incongruence is real, but one is just a 'perversion', the deployment of Autogynephilia as a diagnostic category legitimises this perception. It makes psychologists and psychiatrists complicit in the marginalisation of people who are already heavily marginalised by society. This is a deep betrayal of psychology's basis as a science, and psychiatry's basis as a branch of medicine. The purpose of science is to describe reality objectively, free from the biases and prejudice of phenomenologically lazier forms of discourse. The purpose of medicine is to heal those who are hurting, without harming them further.
'Autogynephilia' does not meet either of these requirements. It is scientifically unnecessary: everything it involves could easily be described in terms of Gender Incongruence. And it is medically abhorrent, as it leaves people who form a normal, healthy part of the gender spectrum with the idea that they are somehow 'wrong', with no possibility of cure, and causes them further harm by legitimising the prejudiced views that they're all just perverts.
None of this means that there are not birth-gendered men who identify as female in a primarily sexual context. For some of these people it is just a fetish, either cross-dressing or enforced feminization. That's fine. For some it goes deeper. There are also, of course, trans women who aren't very sexual. And there are trans women who are very sexual, and trans men of all kinds too. The gender spectrum is just that, a spectrum, on which there are many varieties of experience. This is a concept bourne out by the experiences of people in the trans community and their cis allies every day, but it's a concept which still meets with resistance from the more bigoted sectors of the population. The job of psychologists is to break down this bigotry by revealing the truth about the human psyche. The job of psychiatrists is to help those who are harmed by such bigotry. So the message to the people compiling the DSM-V should be clear: focus on a more inclusive, but still robust, definition of Gender Incongruence, chuck 'Autogynephilia' on the scrap heap with dementia praecox and sexual inversion, and do your bloody jobs. It's what you're there for.
Monday, 1 March 2010
Another Invented Disease
'Girls can cut their hair short...wear shirts and things...because it's okay to look like a boy. But for a boy to look like a girl is degrading, because you think being a girl is degrading.' - Ian McEwan, The Cement Garden (by way, I freely admit, of Madonna's 'What It Feels Like For a Girl')
We haven't talked about Psychology on here in a while; I mean Psychology as a science, rather than the areas in which other posts might trespass on ideas from the discipline. Which is something I really ought to rectify, because all the big beasts of the Psych world are currently getting together, emitting a series of low bass rumbles and high-pitched yammers at each other, and in the process secreting a new edition of the Psychologists' 'Bible', the Diagnostic and Statistical Manual of the American Psychiatric Association, 5th Edition or, to give it it's catchy and ever so slightly fetishy acronym, DSM-V.
I have a copy of DSM-IV on my bookshelf at home, acquired when I was studying Psychology at Sunderland University. It's an interesting book. It has a chequered history. For a long time, Psychologists listed 'homosexuality' as a disease in previous editions of the Manual - DSM-IV is, I think, the first edition which didn't, after a long and protracted campaign. Shamefully, one of the people involved in that campaign was Ron Gold, who, though he did good work on that issue, later ossified into yet another trans-hating cisgay man, spewing crap about how trans people don't really exist on sites like the Bilerico project (I'm not linking to Gold; hateful, cowardly betrayers of liberty will get no through-traffic from this site. Instead, because ze's sound, intelligent, thoughtful and, let's face it, quite the looker, have a gander at Tobi Hill-Meyer's Bilerico columns instead).
DSM-IV also, of course, includes the controversial condition 'Gender Identity Disorder'. Controversial not only because pricks like Gold think it doesn't exist (and even bigger oxygen-thieves like Julie Bindel apparently genuinely believe it was invented as a conspiracy by evil Psychlons to try and trap us all in some Mad Men 50s fantasy world), but also because many trans people resent the idea that they have a 'disorder'. In that respect some good work is being done in the new DSM, in that GID will be replaced with the much more open category of 'Gender Incongruence' which will, quite importantly, be regarded as a curable condition: people who suffer gender incongruence will be considered cured when they have SRS to realign their physical gender with their felt gender. Fair enough.
Of course, as the saying goes, nothing truly brilliant was ever designed by committee and so, of course, the inevitable academic horse-trading on these things means that, in order to satisfy crawling half-humans like Ray Blanchard, - a man so fucking anal that he decided the condition of wanting to have sex with adult humans needed to be technically codified in the same way as a paraphilia, for Satan's sake - we're also getting some rather hateful new syndromes tagged in on the back of Gender Incongruence, specifically 'Transvestic Fetishism' and 'Autogynephilia'. Here's Cheryl Morgan with more on this ugly little bit of theorizing.
There is an awful lot about all this that really incenses me. One thing is the way in which, as a discursive psychologist, I find it repugnant for privileged cis males to define psychological categories which write marginalised people out of their own narratives. But one of the other really annoying things is that, as Morgan points out, 'Transvestic Fetishism' and 'Autogynephilia' are parsed as applying only to 'men' who wear 'women's' clothing or 'imagine' themselves to be women.
Because, of course, it's obvious that girls would want to dress up like boys because, you know, when you're a boy, you'll get your favourite things, other boys check you out etc etc (of course, under Blanchard's categories, Bowie would probably be considered mentally ill for dressing up as a girl in the video for 'Boys Keep Swinging', which shows how medieval Blanchard's thinking really is - it being a truth universally acknowledged that if you think Bowie's wrong, you fail at life), whereas being a boy and wanting to be an icky, yucky, girl is, as any fule kno, clearly a sign of mental illness.
Well, I'm sorry, but if that's the case, then hullo clouds, hullo sky, and colour me fucking crazy. Because if Ray Blanchard is what passes for a supposedly sane human being these days, you can book me a one-way ticket to Arkham Asylum and throw away the key. But then again, it's worth remembering that one of the most disturbed villains in the Batman canon, Jonathan Crane, the Scarecrow was...a psychiatrist.
It's a good thing the Scarecrow's fictional, really. If he existed, they'd probably get him in to chair the DSM-V subgroup on costumed vigilantes.
We haven't talked about Psychology on here in a while; I mean Psychology as a science, rather than the areas in which other posts might trespass on ideas from the discipline. Which is something I really ought to rectify, because all the big beasts of the Psych world are currently getting together, emitting a series of low bass rumbles and high-pitched yammers at each other, and in the process secreting a new edition of the Psychologists' 'Bible', the Diagnostic and Statistical Manual of the American Psychiatric Association, 5th Edition or, to give it it's catchy and ever so slightly fetishy acronym, DSM-V.
I have a copy of DSM-IV on my bookshelf at home, acquired when I was studying Psychology at Sunderland University. It's an interesting book. It has a chequered history. For a long time, Psychologists listed 'homosexuality' as a disease in previous editions of the Manual - DSM-IV is, I think, the first edition which didn't, after a long and protracted campaign. Shamefully, one of the people involved in that campaign was Ron Gold, who, though he did good work on that issue, later ossified into yet another trans-hating cisgay man, spewing crap about how trans people don't really exist on sites like the Bilerico project (I'm not linking to Gold; hateful, cowardly betrayers of liberty will get no through-traffic from this site. Instead, because ze's sound, intelligent, thoughtful and, let's face it, quite the looker, have a gander at Tobi Hill-Meyer's Bilerico columns instead).
DSM-IV also, of course, includes the controversial condition 'Gender Identity Disorder'. Controversial not only because pricks like Gold think it doesn't exist (and even bigger oxygen-thieves like Julie Bindel apparently genuinely believe it was invented as a conspiracy by evil Psychlons to try and trap us all in some Mad Men 50s fantasy world), but also because many trans people resent the idea that they have a 'disorder'. In that respect some good work is being done in the new DSM, in that GID will be replaced with the much more open category of 'Gender Incongruence' which will, quite importantly, be regarded as a curable condition: people who suffer gender incongruence will be considered cured when they have SRS to realign their physical gender with their felt gender. Fair enough.
Of course, as the saying goes, nothing truly brilliant was ever designed by committee and so, of course, the inevitable academic horse-trading on these things means that, in order to satisfy crawling half-humans like Ray Blanchard, - a man so fucking anal that he decided the condition of wanting to have sex with adult humans needed to be technically codified in the same way as a paraphilia, for Satan's sake - we're also getting some rather hateful new syndromes tagged in on the back of Gender Incongruence, specifically 'Transvestic Fetishism' and 'Autogynephilia'. Here's Cheryl Morgan with more on this ugly little bit of theorizing.
There is an awful lot about all this that really incenses me. One thing is the way in which, as a discursive psychologist, I find it repugnant for privileged cis males to define psychological categories which write marginalised people out of their own narratives. But one of the other really annoying things is that, as Morgan points out, 'Transvestic Fetishism' and 'Autogynephilia' are parsed as applying only to 'men' who wear 'women's' clothing or 'imagine' themselves to be women.
Because, of course, it's obvious that girls would want to dress up like boys because, you know, when you're a boy, you'll get your favourite things, other boys check you out etc etc (of course, under Blanchard's categories, Bowie would probably be considered mentally ill for dressing up as a girl in the video for 'Boys Keep Swinging', which shows how medieval Blanchard's thinking really is - it being a truth universally acknowledged that if you think Bowie's wrong, you fail at life), whereas being a boy and wanting to be an icky, yucky, girl is, as any fule kno, clearly a sign of mental illness.
Well, I'm sorry, but if that's the case, then hullo clouds, hullo sky, and colour me fucking crazy. Because if Ray Blanchard is what passes for a supposedly sane human being these days, you can book me a one-way ticket to Arkham Asylum and throw away the key. But then again, it's worth remembering that one of the most disturbed villains in the Batman canon, Jonathan Crane, the Scarecrow was...a psychiatrist.
It's a good thing the Scarecrow's fictional, really. If he existed, they'd probably get him in to chair the DSM-V subgroup on costumed vigilantes.
Monday, 3 August 2009
Days of Pain and Wonder
It's been erratic here these past few days. I'm still adjusting to the divorce, and living here on my own is like some kind of retreat: it's throwing the kind of things with which I have to deal into very sharp focus. If this sounds like therapy-speak, apologies. But next time someone tells you that they're enjoying being alone, because it gives them time to get in touch with themselves and who they really are? Punch them in the face and send them my compliments.
Because it isn't fun at all. I can't speak for all of us but personally, spending time on my own and getting to know myself better is the most goddam depressing thing on earth. One of the many great things about being married, it seems to me, is that suddenly you slot into a position in which your selfhood is defined in relation to someone else. You don't have to work out who you are, because you're x's husband, y's wife, z's secret gay mistress. And this is much less demanding. The other person becomes an anchor, a fixed point around which you construct your persona.
When you lose that anchor, you go into freefall (if no-one minds me mixing metaphors ridiculously for a moment). Suddenly there is no-one to define yourself in relation to: you have to define yourself in relation to, well, yourself. And also, weirdly, everyone else. You have to look at all the other shambling, farting monkeys in the street and say, hell, where do I fit in among all this? Which cage do I have in this zoo? Am I a babboon or an orangutan? Am I a fucking snake?
The idea of going back to the trenches of the tawdry, low-grade state of civil war that passes for sexual relationships in this monkey house doesn't exactly fill me with excitement. Mainly because I've seen the other troops on my side of the lines. I mean, have you looked at men lately? Have you listened to the bastards talk? Have you seen what passes for social interaction amongst 'em? The constant bloody blokiness of it all. Save me, O Blessed Virgin, from ever becoming the kind of man who winks at people and calls them all 'mate.'
It's at times like this when I wish I was a lesbian. Admittedly I possibly have a ludicrously idealized view of the sapphic lifestyle, but for me the chief advantage would be the ability to still date women but not to wind up being associated with the kind of club-brained moron who genuinely thinks he's a modern-day Casanova because he's sprayed some Lynx on underneath his regulation Ben Sherman oxford shirt.
And what's most annoying is that this is the version of manhood which is most widely touted in the culture. It seems these days that if you're not listening to landfill indie, following the football, drinking carling, watching reruns of Top Gear on Dave, and tugging one off over the Girls Aloud calendar, you may as well sign up for the hormone treatments and select your pre-op wardrobe. Why? Why isn't there more of a space for less obvious kinds of masculinity? I mean I don't begrudge the Clarkson-wannabes having some space, I just wish they hadn't colonised almost every inch of the man-territories, leaving those of us who don't buy into the whole package trapped in a tiny metaphorical village like some weird genderqueer version of Asterix.
So, yeah, these are the thoughts which have been carroming around my head of late. On the other hand, though, it's not all bad news. After four years of beating myself against the byzantine bureaucracy that is the world of the mature student, after endless writing of reports, interview transcripts, essays and pages and pages and pages of bloody bloody references, I have at last finished my postgrad psychology diploma. I can do science, me.
Because it isn't fun at all. I can't speak for all of us but personally, spending time on my own and getting to know myself better is the most goddam depressing thing on earth. One of the many great things about being married, it seems to me, is that suddenly you slot into a position in which your selfhood is defined in relation to someone else. You don't have to work out who you are, because you're x's husband, y's wife, z's secret gay mistress. And this is much less demanding. The other person becomes an anchor, a fixed point around which you construct your persona.
When you lose that anchor, you go into freefall (if no-one minds me mixing metaphors ridiculously for a moment). Suddenly there is no-one to define yourself in relation to: you have to define yourself in relation to, well, yourself. And also, weirdly, everyone else. You have to look at all the other shambling, farting monkeys in the street and say, hell, where do I fit in among all this? Which cage do I have in this zoo? Am I a babboon or an orangutan? Am I a fucking snake?
The idea of going back to the trenches of the tawdry, low-grade state of civil war that passes for sexual relationships in this monkey house doesn't exactly fill me with excitement. Mainly because I've seen the other troops on my side of the lines. I mean, have you looked at men lately? Have you listened to the bastards talk? Have you seen what passes for social interaction amongst 'em? The constant bloody blokiness of it all. Save me, O Blessed Virgin, from ever becoming the kind of man who winks at people and calls them all 'mate.'
It's at times like this when I wish I was a lesbian. Admittedly I possibly have a ludicrously idealized view of the sapphic lifestyle, but for me the chief advantage would be the ability to still date women but not to wind up being associated with the kind of club-brained moron who genuinely thinks he's a modern-day Casanova because he's sprayed some Lynx on underneath his regulation Ben Sherman oxford shirt.
And what's most annoying is that this is the version of manhood which is most widely touted in the culture. It seems these days that if you're not listening to landfill indie, following the football, drinking carling, watching reruns of Top Gear on Dave, and tugging one off over the Girls Aloud calendar, you may as well sign up for the hormone treatments and select your pre-op wardrobe. Why? Why isn't there more of a space for less obvious kinds of masculinity? I mean I don't begrudge the Clarkson-wannabes having some space, I just wish they hadn't colonised almost every inch of the man-territories, leaving those of us who don't buy into the whole package trapped in a tiny metaphorical village like some weird genderqueer version of Asterix.
So, yeah, these are the thoughts which have been carroming around my head of late. On the other hand, though, it's not all bad news. After four years of beating myself against the byzantine bureaucracy that is the world of the mature student, after endless writing of reports, interview transcripts, essays and pages and pages and pages of bloody bloody references, I have at last finished my postgrad psychology diploma. I can do science, me.
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