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."
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 Is Tonti-Filippini is referring to an outdated edition of the DSM?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
"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.