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Kate Orman
News From the House of Sticks
 
4th-May-2009 11:03 am
HOLD ON
Today's SMH tries hard to make an exciting issue out of a Family Court order that a seventeen year old transgender boy have his breasts removed now, rather than waiting until he's eighteen. This is just the next step of the boy's treatment, which has been proceeding since he was thirteen; the only reason a court order was required was that he's still a minor. "Transgender boy's successful therapy continues" wouldn't be much of a headline, of course; "Court supports girl's wish to be a boy" is more catchy (and The Age has gone for broke with "Court lets girl, 17, remove breasts"). But to beef up the article a bit, we have some Controversy:
But the ethicist Nick Tonti-Filippini said mainstream medicine did not recognise hormone treatments and surgery as treatment for gender dysphoria. He said it was a psychiatric disorder qualifying under US guidelines as a psychosis because "it's a belief out of accordance with reality".

"What you are trying to do is make a biological reality correspond to that false belief."
Uh...

OK. For a start, the American Psychiatric Association states that "appropriately evaluated individuals benefit from gender transition treatments", citing numerous studies. You can't get much more "mainstream" than that.

As for "psychosis": I assume Tonti-Filippini is referring to the APA's Diagnostic and Statistical Manual of Mental Disorders, the standard handbook which names and defines different psychological conditions. The entire entry on gender identity disorders is reproduced online here. Although the terms "psychosis" or "psychotic" are found throughout the manual, they're conspicuous by their absence from the entry on GID. So I'm stumped. Is Tonti-Filippini is referring to an outdated edition of the DSM? To some other set of mainstream diagnostic guidelines? Or, just possibly, to guidelines used by therapists who try to counsel transgender children and adolescents into becoming cisgender?

The Age also quotes Tonti-Filippini:
"But medical ethicist Nick Tonti-Filippini warns there can be grave outcomes for people such as Alex. 'People who have sex changes have just on 20 times the suicide rate of the rest of the population. They are a major risk. They also have very high rates of unemployment.'"
Yeah, can't think why that might be, mate.
Comments 
4th-May-2009 02:24 am (UTC)
Have to admit that even I was pretty stunned by the insensitivity of the media's "girl has breasts removed" headlines.
4th-May-2009 03:06 am (UTC)
Hey Kate, have you read this excellent post by Anna Tambour?

http://medlarcomfits.blogspot.com/2009/04/hear-joke-about-vatican-and-science.html

I'm wondering how diverse the pool of 'medical ethicists' that the papers draw from is?
4th-May-2009 03:10 am (UTC)
Well, here's what they didn't tell you: Tonti-Filippini works for this extremely dodgy looking Catholic "maternal care" organization.

The funny thing is that here this creep is out of step with even wacky Protestant fundamentalists, who are all in favour of SRS as long as the new woman or man behaves heterosexually aftewards.
4th-May-2009 05:34 am (UTC)
this post is from Anna Tambour who is having techy difficulties posting to your comments:

"This post of mine

[http://medlarcomfits.blogspot.com/2009/04/hear-joke-about-vatican-and-science.html]

is really a shot against the bows of what's happened in Australia-- our public policy and laws are increasingly being shaped by the Church. When the government-owned ABC and SBS TV and radio stations interview an 'ethicist', it's always one of them, but this identification is never made. This Prize is typical of the taking over of every "ethics" post by Catholic "ethicists", which should garner the same public reaction as McDonalds determining public nutrition standards. Every federal and state body where there is an ethics post is infected by the Christian right, most often not in the 'religious community' position, if there is one. I'd rather be on a small boat crossing the English channel in a storm than have to sit silent again when a Vatican minion talks about evil in her capacity as a member of a National Health and Medical Research Council Committee."

In fact, Tonti-Filippini has a lock on the "ethicist" position whenever the media quotes one, and he is not only is not identified as a Vatican emissary, but he lists himself as "independent". This is how he should always be seen.
http://www.jp2institute.org/admin_tonti.html

The Church has a grip on the ethics positions in bodies that formulate state and federal policy such as the National Health and Medical Research Council. But even when there is a 'religion' post, they take up other posts too, so that they rule by stealth.

Tonti-Filippini is ubiquitous, but he is not alone. Here are two others who are also prominent.
Bernadette Tobin, Director of the Plunkett Centre for Ethics in Health Care, a joint research centre of St Vincent's Hospital and Australian Catholic University
Reverend Bill Uren, Jesuit priest
4th-May-2009 09:44 am (UTC)
V. v. interesting - thanks. It's not completely clear from the newspaper articles whether Mr. T-F was invited by the judge to play Devil's advocate at the hearing, or just rung up by the Age for some quotes to make their report more interesting. In either case, if this is the usual quality of his testimony, we're in trouble.
4th-May-2009 06:56 am (UTC)
I'm kinda trying to figure out why quoting supposed US guidelines (assuming it was an accurate representation) should have anything to do with how another country handles things. :/
4th-May-2009 01:34 pm (UTC)
Largely because the US is the only country (AFAIK) to have produced such a complete and thoroughly researched set of guidelines (mainly 'cos they have a big population of patients to test things on and a big population of shrinks and medics to do all the necessary testing). The APA's DSM-IV is basically the international standard for diagnosing mental illness; (Some) other countries base their guidlines on DSM-IV, just issuing overriding documents where they happen to significantly disagree on something.
4th-May-2009 03:33 pm (UTC)
Ah, okay, thanks -- that makes a bit more sense than I'd originally thought.
4th-May-2009 10:14 am (UTC)
Can you submit this to Media Watch? :/
5th-May-2009 01:12 am (UTC)
Heck, that's a good question - depends on whether there are standards on reporting stories about transgender people which the papers have violated. I'll see what I can find out.
4th-May-2009 10:44 am (UTC)
I saw that mentioned on Today, of all places. It certainly wasn't the most insensitive coverage of TG issues I've seen in news media... that the presenter referred to the teenager as a 'girl' and 'she' didn't help matters.

(I know some people do this because they're honestly underinformed, but to me it seems to imply - deliberately or not - that gender dysphoria and its treatment are some kind of whim if girls cutting off their breasts becomes the thrurst of the report.)

(And yeah, it also left out the 'treated since thirteen' part.)
4th-May-2009 06:01 pm (UTC)
...Yeah, I was a bit peeved at the Beeb for initially headlining this story with female pronouns. Fortunately they used male ones for most of the rest of the story. It did seem a bit bodged-together from assorted wires rather than carefully reported from their guys, though. Sigh.
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