"Reversal of fortune? No way. Reversal of skill." -Uffish Thought
Question #89646 posted on 05/18/2017 2:29 p.m.
Q:

Dear 100 Hour Board, particularly Van Goff and Black Sheep,

I have a question about transgenderism. I'd like to first start with a disclaimer: I really, truly want to understand (I'm not a troll). I also want to be respectful of others, and I will happily use whatever pronoun another person prefers, and I fully support anyone's efforts to live in a way that makes them happy. Privately, however, I'm trying to understand what transgender really is and why it is and where it fits. So here we go:

I don't understand the idea of your birth sex not matching your internal sense of gender. I'm a straight cisgender woman, and maybe this is one of those things I just can't understand, but I've really thought about what it is in me that feels female, and I don't have it. I'm female because I have a vagina and breasts. I like a lot of typically female things, but I don't feel inherently one sex or the other. Can you talk a little bit about this? Because this question leads to my next one -

Is transgenderism more a product of our hyper-gendered culture than anything else? If we lived in a world where we were truly free to be whatever kind of man or woman we were, would there be transgender people? What if we were so genderblind that gender and sex were truly the same thing?

Finally, and please don't hate me, but I don't understand how transgenderism isn't a form of body dysmorphia. There was an article about this a long time ago that popped up on my Facebook feed, and the comments on it were blistering. I really didn't want to get involved in a comment war, but at the same time, I wanted to understand, and I didn't see how that was such an extreme leap. Isn't body dysmorphia the disconnect between what's in the mirror and how you feel? And if so, isn't a better support for transgender people some kind of therapy to help them learn to love themselves as they are?

Again, please don't hate me. I just don't know where else I can ask.

-Her

A:

 Dear reader,

I think it's kind of you to want to understand. Thanks for the question. 

I don't want to take away from Van Goff's answer, because it is fantastic, but something in my Sociology 111 class a few years ago helped me understand and feel less frantic about such things. 

Take two boxes, like so:

IMG_3038.JPG.jpeg

And divide them into three components— the inside, the box itself, and sticky notes that students filled with stereotypical attributes of genders, like so:

IMG_3039.JPG.jpeg

(I couldn't find the traditional pink and blue, so this will have to do. Also, please excuse my relaxed-looking position; exercise classes make it hard to sit properly.)

These sticky notes said things like 

  • selfless
  • "doesn't know she's beautiful" or arrogant
  • not funny
  • sensitive and thoughtful
  • long hair
  • nice or "witchy" (BYU apropes, folks)
  • long hair
  • emotional
  • graceful/elegant
  • make up
  • cares about appearance
  • soft
  • tempered
  • happy/smiley
  • prudish
  • good with kids
and
  • tall/buff/handsome/dark
  • lacks emotions except anger/stoic
  • short hair/facial hair
  • stubborn
  • nice or tool-ish
  • gruff
  • strong
  • analytical/cold
  • boss
  • naturally good-looking or not/casual towards appearance
  • ill-willed/bad temper
  • doesn't dance
  • obsessed with sex
  • good with finances
Some are superficial examples, but they can symbolize deeper beliefs. 

The sticky notes represent conventional and cultural distinctions/roles of gender, or the social construct of it. These start even before birth (buying blue pants versus a yellow dress) and change from culture to culture and place to place. 

For example, in the US it can be difficult to be "manly" if you dance; in not-too-ancient Hawaii the men were the only ones who danced. In the States some moms often become a pseudo-chauffeur for their kids and general errands; in Peru my friend's dad, who is a fantastic man, was inspired to start working as a taxi driver because he saw a woman doing it and thought, "If a woman can drive a car, I can drive a car." (In a YSA Sunday school lesson I attended in another part of South America, the sage teacher taught us this passed-down wisdom: "Don't treat her like a woman; treat her like a person." Right? Sticky notes.)

The sticky notes are different in every time and in every space: Kelly and Ashley used to be exclusively male names. In ancient times, men wore skirts and dresses (though they're more commonly referred to as robes), and longer hair was more common. In some cultures men do/did all the shopping (hunting and gathering), but in others they stay(ed) home and cook(ed). Many cultures are coming to a convergence of responsibilities, but it's not without heavy resistance from multiple parties. (See, for example, Parks and Recreation S7 E9, "Pie-Mary")

(Sidebar: Sociologists have found that masculine qualities are basically more desirable for either gender. That is, when women are told they're masculine, it's not that big a deal; when men are told they're even slightly more feminine, they fight it and try to overcompensate. This could explain why traits (like names) sometimes switch from exclusively male to exclusively female, but it's almost never the other way around.) 

The boxes themselves are the biophysical sex, which is usually straightforward but can be intersex or somewhere between the two. This happens anywhere between every 4 in 100 cases to 1 in 2,000 cases, depending on who you talk to and how they classify things. If you want to, you can read more about that here, here, here, or Wikipedia. Certain aspects of this, like height or hair growth, may also differ from region to region. Anyway, not the main point. 

The inside of the boxes is what is being referred to in things like The Family: A Proclamation to the World. That's the thing that sticks around and what is part of "eternal identity and purpose."

The proclamation divides duties for a father and mother respectively between "presid[ing] over their families in love and righteousness and... provid[ing] the necessities of life and protection for their families," and having primary responsibility "for the nurture of their children." Note that those are the only differences between the genders in the document — all other responsibilities, warnings, and blessings are given to parents as a unit, or to children of God individually. 

It continues, "In these sacred responsibilities, fathers and mothers are obligated to help one another as equal partners. Disability, death, or other circumstances may necessitate individual adaptation" (emphasis added).  The other circumstances could include culture, skill, job market and educational background, etc. 

Essentially, we are given principles to give a foundation to our lives, but the exact details are not prescribed to us. Some people and cultures try to adjust that and set limits as to what counts as nurturing, presiding, or providing. Of course, some stability and even rules are key to fostering understanding, but in my amateur etymological studies of the words, it is clear that they represent a vast wealth of applications.

In other words: we are a global church representing a universal gospel, and culture varies. People change and so do their customs, but truth, and the inside of the box, lasts. 

--

So, from my still very limited understanding, I would think being transgender is less an issue of body dysmorphia and more an issue of not being able to breathe because of all the sticky notes. I know that's a little tongue-in-cheek-y, but I don't want to tread deeper because I don't know things, and because those who do (like Van Goff) should be looked to for that. 

But here are some things I do know:

-Sticky notes create distance between souls, and too much time with them can make it more and more difficult to distinguish arbitrary attributes from truth. But we are called to love and serve souls, so we need to learn what those are exactly.  

-As far as supporting people— in any difficulty or personal struggle, but especially with this— I feel strongly that sometimes acts claimed to be done out of love for others are really done out of a desire for comfort. Sadness and hardship and not-knowing-who-you-are-or-might-be is uncomfortable. Witnessing discomfort is uncomfortable. AND (not but) these things are crucial to growth and development, and to love. If we deny people appropriate time to feel, how are they supposed to come to know themselves? 

-Without that respect, a frantic crusade to fix a perceived problem will create wreckage of souls. And that, in my opinion, is unacceptable. 

Take care,

-Auto Surf

A:

Dear friend,

Not at all! These are very valid questions, and the way you asked them was incredibly respectful. I am honored that you'd come to me with them. You might want to keep in mind that as a trans person, I have an inherent bias that you might want to take into consideration. On the other hand, though, I am probably more familiar with these questions and have spent more time thinking about them than most. Let's take them one at a time, and I'll see if I'm able to shed a little light on your confusion. Sorry this post is long and probably more than you asked for. I wanted to be as thorough as possible to clear up any questions, so apologies if it rambles.
 
How does someone "feel" like a certain gender? What is gender dysphoria?
 
For the first question, it sounds like you're confused about why trans people experience discomfort in their bodies and what feeling like one gender or another means. It is a little tricky to define what it means to "feel" male or female. I don't think there is an easy answer because people connect with their gender identity differently.
 
It sounds like it would be helpful to explain the concept of dysphoria and how it relates to transgender identity. Gender dysphoria is the conflict between a person's physical gender and what they identify as. This causes a significant amount of distress for the person and dissonance between how they feel and their assigned sex (called "dysphoria"). Gender dysphoria affects different people in different ways, and people cope with it differently: some socially transition, some medically transition via hormones or surgery, and some take smaller steps based on what works for their situation.
 
As for what makes someone feel "male" or "female," generally trans people experience physical dysphoria, social dysphoria, or a little of both. From what I can understand in your question, you do not feel physical discomfort about your female sex characteristics. For that reason, I'm guessing you do not have physical dysphoria. It also sounds like you don't have social dysphoria because you don't feel discomfort or dissonance when people refer to you as female. 
 
My dad had similar questions for me when I came out to him, and for a long time he had a hard time grasping what it meant to feel like a man or a woman.  It helped him when I asked him to imagine that one day, he woke up and suddenly he had breasts and people were referring to him as female. He felt that though he could not quite express why, he was adamant that he would feel very uncomfortable. In some ways, that is what it's like for me except that it's not a thought experiment.
 
It might help you to imagine that one day you woke up and you had the physical traits of a male and your female features were gone, replaced by male characteristics. Would you feel uncomfortable or out-of-place in your body? Would you be comfortable in a male body, or would you feel that something was missing? What if people started referring to you as male? What if you were expected to adhere to male cultural roles and (going with the detail that you are a straight cis woman) being attracted to and marrying a woman (or relating to men romantically as a gay/queer man which, I can say from experience, is surprisingly different from romantically relating to men as a woman)? Would you adapt to these changes right away, or would you feel a disconnect with your body and your place in society? I don't know you and can't say what you're feeling, but if you felt discomfort at this prospect, that might mirror to some extent what trans people go through.
 
But in some ways, gender identity and gender expression can be a bit of a spectrum, and many people don't feel "male" or "female" necessarily. This is normal and okay, even in an LDS context where gender is considered an eternal trait. To divulge on that a little more, I direct you to the next section where we will talk a little bit about gender identity vs. gender expression vs. biological sex. 

Gender Identity VS. Gender Expression VS. Sex: Meet the Genderbread Person

When it comes to gender, there is a difference between one's gender identity and one's gender expression. Both can influence how one connects with gender, and both are more of a spectrum than binary necessarily (much like physical attraction). So a person could easily not feel "male" or "female" necessarily nor really care about their gender so long as they're not feeling dysphoria. To make it a little less confusing, here is a helpful diagram. Say hello to the Genderbread Person!
 
Genderbread-Person-3.3.jpg
 
 
Hello, Genderbread Person!
 
The Genderbread Person is here to help us understand the gender identity spectrum, the gender expression spectrum, and the biological sex spectrum. All three contribute to how a person connects with their gender/biological sex. They are all very distinct and are experienced on a spectrum.
 
Biological sex is, of course, the sex you are born as. This would include your sex chromosomes and any outward physical traits of a certain sex. Most people are either one sex or the other, but in the case of intersex conditions, one can be somewhere in-between. In this way, biological sex is a spectrum. If a person feels dissonance or discomfort with their biological sex characteristics, their gender identity or expression may be distinct from their gender expression.
 
Gender identity is your self-concept of being male, female, or somewhere on the spectrum (in the case of non-binary individuals). This is separate from biological sex in that a person could perceive themselves as one gender but physically be another one. Why this can happen is unknown: some researchers believe that it's possible to have a "male" or "female" brain while having a different body because of how the body develops in the womb. From a religious perspective, it is postulated that maybe one could have a female soul while being born in a male body, or vice-versa. But on a basic level, gender identity is how an individual perceives themselves.
 
Gender expression is the external appearance of "masculinity" or "femininity," usually conveyed through behavior, clothing/hairstyle, and cultural roles. A person might not conform to roles given based on their sex or gender identity. There are feminine men, for example, and masculine women. There are also people who express their gender androgynously, meaning that they have both masculine and feminine traits. Most people are somewhere in-between and not completely feminine or masculine.
 
So, tying this back to the point before it gets out of hand, how a person connects with their gender is complicated and not necessarily on one end of the spectrum fully. You are a biological female (assuming you are not intersex) who is not uncomfortable with their body, so it sounds like your sex and gender identity are both completely female. Because you do not feel discomfort at being female, it sounds like your self-concept has developed as being a woman without any dysphoria.
 
Your gender expression might be somewhere in-between, which could be why you don't quite grasp what makes you a woman. But it could be that because you don't feel discomfort about biological sex, that your gender identity has never been disturbed so you just haven't had a need to think of it. I could very much be wrong here, but maybe it's harder to understand physical dysphoria in its absence (especially if you are not a feminine-presenting person and you feel no discomfort about your biological traits).
 
On a religious level, it might sound kind-of sacrilegious to say that sex, gender identity, and gender expression are all on a spectrum because, as stated in The Family: A Proclamation to the World, gender is an eternal characteristic. So where do intersex, non-binary, and androgynously-presenting people come into play? It's hard to say, and I admit that, to quote Nephi, "I know that [God] loveth His children, but nevertheless I do not know the meaning of all things." (1 Nephi 11:17) He loves us, He knows our concerns better than anyone, and maybe through cleaving to Him and developing that personal relationship, we can understand how we as an individual fit in terms of our gender identity/expression/sex in terms of this doctrine. But I don't feel comfortable hypothesizing any further than that (especially when I am not non-binary or intersex). There is too much that religiously/doctrinally, scientifically, and culturally that is not clear at this time.
 
Is transgender identity a product of a hyper-gendered culture? Would there be trans people if we lived in a society where we could be any kind of man or woman we wanted? What if we were so "genderblind" that gender and sex were truly the same thing? (And is being "genderblind" an ideal?)
 
Interestingly enough, transgender statistics have risen in the US alongside gender equality. The more free a person feels they can be in gender identity or expression, the more likely they are to be open with their gender identity. As mentioned earlier, gender identity and gender expression are separate. A trans person most likely isn't transitioning because they feel very masculine or feminine. There are also plenty of trans women who love sports and trans men who enjoy musicals (to use feminine and masculine stereotypes).
 
There are plenty of masculine women and feminine men and, while it can be socially difficult to be either, it is culturally much easier to identify as either of those than to identify as a transgender person. It's not so much about a hyper-gendered culture as it is feeling a dissonance between gender identity and biological sex. It doesn't have anything to do with cultural stigma of masculine women or feminine men, otherwise all masculine women would transition to male when most of them are very comfortable being women (and vice-versa with feminine men).
 
Now to tackle the idea of being "genderblind": is being genderblind a cultural ideal, and is it a good idea to erase all differences between men and women? It sounds much like being colorblind which, while well-meaning, is not healthy for society. We learned in one of my training courses last fall that colorblind ideology is actually a form of racism. The problem is that it allows people to effectively ignore racism, justify the social order, and feel more comfortable with their privilege. Being "colorblind" is saying to people of color that white people do not see them, that they are more comfortable with white culture so they will ignore any heritage other than their own, and that there is something shameful about being of another culture.
 
Being genderblind, then, would likely also be a form of sexism and unhealthy for society. There are differences between women and men, some biological and some cultural, and ignoring these differences does not benefit anyone. It could ignore sexism, justify a patriarchal order, and allow cis men to feel comfortable with their privilege. It is saying to women (and non-cis people) that cis men do not see them, that they are uncomfortable with any gender but their own, and that differences between genders are shameful and wrong. 
 
A common thought experiment is to ask a trans person to imagine they were alone on an island, far away from civilization and any form of culture. Would they still feel dysphoria? Most say yes because their dysphoria is much more than gender expression: it is an inherent part of their gender identity, and it doesn't disappear when social pressures are removed because social pressures don't cause it.

What is the connection between gender dysphoria and body dysmorphia?
 
There is a connection between gender dysphoria and body dysmorphia, but not in the way that this question phrases it. Many trans people develop eating disorders either out of self-hatred or to suppress certain physical traits (such as feminine curves for trans men or muscles for trans women). In a nutshell, transgender people are more likely to develop these disorders but they are not the same.
 
A person with anorexia or bulimia believes they are fat when they are most likely not. A transgender woman knows that they are biologically male: they hold no "delusion" or "wrong thought pattern" that they are biologically female. They know that they have male physical traits, and that distresses them. To have an eating disorder is to incorrectly believe that their body is overweight. To have gender dysphoria is to know that your physical body is not in alignment with your gender identity and to feel depression or distress. One is a distorted view of reality, one is not.

Isn't better treatment to get trans people to "love themselves as they are?"
 
Not necessarily. Suppose you met a person who wasn't born with legs. Would the best therapeutic treatment be to help them "love themselves without legs" because God intended them to be legless, or would it be to help them find some prosthetics? The prosthetics are fake. If they take them off, they don't have legs. So is it against religious nature for them to wear prosthetics so that they can walk like other people? In a similar light, a person with gender dysphoria may not biologically be the gender they perceive themselves as, but socially they present as the gender they feel most comfortable with--much like a person born without legs might use prosthetics instead of being fully confined to a wheelchair.
 
Or would it be medically correct to tell a diabetic person that because their body does not produce insulin that God wanted them to experience extremely high and low blood sugar? My cousin takes insulin from an artificial pump because her body doesn't produce it. Some trans people take hormones by pills or injection (both those who socially transition and those who do not) because their body doesn't produce those hormones. A diabetic person's pancreas will never produce insulin, nor will a trans man's body ever produce testosterone, but it's a medical treatment in both situations.
 
Perhaps I'm a bit forward thinking, but I believe that in the future, therapy based around trying to help a transgender person become more comfortable with their biological body will be viewed similarly to gay conversion therapy. In very few cases, it might work, but in the majority of cases, it has the potential to be very harmful. Treatment for gender dysphoria in a psychological/medical sense isn't for the person to "love themselves as their biological gender" or getting rid of the feelings because it doesn't usually work. Treatment more involves dealing with the distress behind these feelings. This can involve individual counseling, group or family therapy, social or hormonal transitioning, or surgical reassignment. It could be just therapy, or it could be all of these things, but it is not usually effective to treat gender dysphoria as something to correct or remove.
 
Treating the distress behind gender dysphoria instead of the gender identity itself is generally seen as successful. Transgender people have a high depression and suicide rate, at around 41% attempting suicide. The less distress a trans person feels towards these feelings (via therapy or transitioning steps), however, and the less they feel socially shamed for their gender identity, the lower their suicide rate is. When transgender people have affirming parents, for example, this rate drops by 56%. Ability to social transition and legally change their gender, and it drops by 66%. Transgender children who are supported in their identities by their families and the society around them have depression rates no higher than the rest of the population and only slightly higher anxiety rates.
 
This is in contrast with dysmorphic disorders like anorexia, for example, where encouraging pro-anorexic behaviors eventually drives that person to starvation or suicide. Transgender treatment is different in that the more a person accepts their gender identity, and the less transphobia they face, the less likely they are to feel suicidal and the happier lives they lead.
 
Personally, therapy is what helped me come to terms with all the same I felt about being transgender and deal with transphobia I felt inside. It helped me deal with my body in healthy ways and tear down walls of self-hatred. For so many years, I hated myself and especially my body. Everything about me felt repulsive, and I felt like God made a mistake when He created me or I had done something wrong that deserved His wrath (ie: that gender dysphoria was a punishment). Once I began to dress masculinely/transition, go by a male name, and start to accept that while biologically female, I felt like a man, all that shame started to melt slowly. It took a lot of emotional sorrow and a people who stood by me and loved me even while I transitioned for me to finally be okay with myself again. I still feel pain, but it is so much less than before I transitioned. I don't feel like God made a mistake when He created me transgender anymore, I do think there was a reason, but I also don't know what that reason is. I just know that for now, I am at peace, and that maybe I will understand more someday. That's enough for me.
 
I don't think I could have developed that contentment by "loving myself as a woman" any more than someone with same-sex attraction can force themselves to be physically attracted to the same gender. Just as they are just not attracted to the opposite gender, I never felt like a woman. Not all people with gender dysphoria transition, but many take steps to connect with their gender identity in ways that are not "loving themselves as their biological gender" (such as taking hormones or wearing the clothes of the gender they feel they are). Maybe someday there will be better medical treatment, but right now, it's the best we've got.
 
It's a hard thing to understand, and I think a lot of trans/non-binary people grapple with this confusion, too. If I wasn't trans, I don't think I'd understand it even a little bit. You're wonderful for trying to understand and broaden your perspective a little. These are all pretty simplistic answers, so if you have any follow-up questions, feel free to email (van.goff@theboard.byu.edu). If any readers would like to submit a correction or add their opinion for the benefit of the question asker (especially if they have a different perspective), feel free to do so or comment on the Board Comment Board.
 
Again, hope this helps, and sorry this is so long and rambling!
 
-Van Goff

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